A 50-year-old man with esophageal carcinoma developed severe, refractory, retrosternal chest pain. The diagnosis was made four days later when contrast studies showed an intramural dissecting hematoma of the esophagus. The patient responded to conservative management.

Intramural hematoma of the esophagus is a rare but well described type of acute injury of the esophageal wall and it is more frequently being recognized throughout the world. Patients usually present with acute retrosternal or epigastric pain, minor hematemesis and dysphagia. The condition is mostly seen in women with abnormal coagulation and it can either occur spontaneous or induced by trauma...

A 63-year-old woman, with no previous medical history, presented to the emergency room with severe retrosternal chest pain and shortness of breath. Her d-dimer level was raised at 1100 ng/mL. A pulmonary embolus was suspected, and she was administered a therapeutic dose of low molecular weight heparin. A computed tomography of thorax revealed a dilated esophagus and a dissecting intramural hema...

We thank Dr Bing Hu for his interest about our publication, and we read with attention his similar cases. It is interesting to note that intramural esophageal dissection (IED) is characterized by transverse and longitudinal separation of the mucosal and submucosal layers of the esophageal wall, with or without perforation, and it is also known as intramural hematoma of the esophagus (IHE). Howe...

introduction: cardiovocal hoarseness (ortner’s syndrome) is hoarseness of voice due to recurrent laryngeal nerve involvement secondary to cardiovascular disease. recurrent laryngeal nerve in its course (especially the left side) follows a path that brings it in close proximity to numerous structures. these structures interfere with its function by pressure or by disruption of the nerve caused b...