Intramural Dissection of the Esophagus Endoscopic Findings

Intramural esophageal dissection is a rare but well described condition that is characterized by a laceration between the esophageal mucosa and submucosa but without perforation. It is usually associated with a rapid increase in intraesophageal pressure, especially in the presence of coagulation disorder. Intramural esophageal dissection revealed by an upper gastrointestinal endoscopy was reported in a uremic case with sudden onset of hematemesis and anterior chest discomfort during admission. An active ulcer with bleeding in the duodenal bulb and multiple small ulcerations in the antrum and corpus of the stomach were also noted and immediately treated by injection therapy for duodenal bleeding. The patient was discharged completely asymptomatic. Three months later, follow-up upper endoscopy showed a healed scar in the duodenal bulb. The esophagus and the stomach were normal. ( J Intern Med Taiwan 2006; 17: 302-305 )