Rare spontaneous extensive annular intramural esophageal dissection with endoscopic treatment: A case report  

作　　者：Jian-Wen Hu Qian Zhao Chi-Yv Hu Jie Wu Xiang-Yin Lv Xiang-Hong Jin 

机构地区：[1]Department of Gastroenterology,Dongyang People's Hospital,Dongyang 322100,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2021年第36期11467-11474,共8页世界临床病例杂志

摘　　要：BACKGROUND Intramural esophageal dissection(IED)is a rare disease that should be considered in patients with chest pain,dysphagia,and hematemesis.Although it occurs most frequently in older adult women with impaired coagulation or as a sequela of endoscopy,the incidence of spontaneous IED without an obvious causative agent has risen gradually.CASE SUMMARY This report describes a case of extensive annular IED in a 75-year-old male patient who presented with dysphagia for the past month.Esophageal barium meal radiography revealed slow passage of diluted iohexol through the esophagus after swallowing,prominent luminal dilation,obstruction of the lower segment with only a small amount of contrast medium entering the gastric cavity,and no obvious extravasation.Gastroscopy revealed smooth esophageal mucosa;several esophageal mucosal bridges and webbed mucosa were observed approximately 22 cm from the incisor.The mucosal surface was occasionally rough and uneven,and the length of the esophageal mucosal defect exceeded 10 cm.The anatomy was considered to be annular because the mucosal bridge connecting the proximal and distal tube was not attached to the surrounding myotubes.The final diagnosis was spontaneous extensive annular IED.We treated the patient successfully using endoscopic esophagotomy,which completely relieved the symptoms without complications.CONCLUSION Spontaneous annular IED can be treated successfully by endoscopic resection of the mucosal septum between the true and false lumen.

关 键 词：ESOPHAGECTOMY Rupture Esophageal mucosa Case report 

分 类 号：R655.4[医药卫生—外科学]