Abstract
We report a case of spontaneous submucosal dissection of the esophagus of a 58-year-old patient. In September 2005, he complained of chest pain followed by vomiting. Endoscopy showed an ulcerative lesion in the entire circumference of the middle esophagus. No malignant cells were observed in biopsy specimen. The patient received therapy with hyperalimentation, a proton pump inhibitor, and Alloid G. The lesion healed under conservative treatment with a good clinical course and without the development of stenosis. One year later, we performed 24-h pH monitoring and esophageal manometry to clarify the pathogenesis of submucosal dissection in this patient. There was no gastroesophageal reflux, but the manometry test revealed decreased amplitude in the portion of the esophageal lesion that was considered to be caused by fibrosis resulting from inflammation. Two years later, the patient had no complaint of dysphagia. Further follow-up is needed for such a case.
This is a preview of subscription content,
to check access.





References
Williams B. Oesophageal laceration following remote trauma. Br J Radiol. 1957;30:666–8.
Marks IM, Keat AD. Intramural rupture of the oesophagus. BMJ. 1968;3:536–7.
Fujiya M, Saito H, Watari J, Inaba Y, Itou T, Sakamoto A, et al. Pemphigus, pemphigoid. Stomach Intest. 2003;38:473–80.
Lai WW, Wu MH, Shin JS. Submucosal esophageal dissection—a rare case report. Hepatogastroenterology. 1999;46:2419–21.
Jung KW, Lee OJ. Extensive spontaneous submucosal dissection of the esophagus: long-term sequential endoscopic observation and treatment. Gastrointest Endosc. 2002;55:262–5.
Hanson JM, Neilson D, Pettit SH. Intramural oesophageal dissection. Thorax. 1991;46:524–7.
Murata N, Kuroda T, Fujino S, Murata M, Takagi S, Seki M. Submucosal dissection of the esophagus: a case report. Endoscopy. 1991;23:95–7.
Biagi G, Cappelli G, Propersi L, Grossi A. Spontaneous intramural haematoma of the oesophagus. Thorax. 1983;38:394–5.
Berliner L, Redmond P, Pachter HL. Spontaneous intramural perforation of the esophagus: case report and review of the literature. Am J Gastroenterol. 1982;77:355–7.
Morritt GN, Walbaum PR. Spontaneous dissection of the oesophagus. Thorax. 1980;35:898–900.
Hsu CC, Changchien CS. Endoscopic and radiological features of intramural esophageal dissection. Endoscopy. 2001;33:379–81.
Spiller RC, Catto JVF, Kane SP. Spontaneous dissecting intramural haematoma of the oesophagus: a rare cause of haematemesis and dysphagia. Endoscopy. 1981;13:128–30.
Steadman C, Kerlin P, Crimmins F, Bell J, Robinson D, Dorrington L, et al. Spontaneous intramural rupture of the oesophagus. Gut. 1990;31:845–9.
Kerr WF. Spontaneous intramural rupture and intramural haematoma of the oesophagus. Thorax. 1980;35:890–7.
Phan GQ, Heitmiller RF. Intramural esophageal dissection. Ann Thorac Surg. 1997;67:1785–6.
Lowman RM, Goldman R, Stern H. The Roentgen aspects of intramural dissection of the esophagus. Radiology. 1969;93:1329–31.
Kuo YC, Wu CS. Spontaneous intramural perforation of the esophagus: case report and review of the literature. Endoscopy. 1989;21:153–4.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Higashida, M., Hirai, T., Matsumoto, H. et al. A case of spontaneous submucosal dissection of the esophagus. Esophagus 8, 125–130 (2011). https://doi.org/10.1007/s10388-011-0265-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10388-011-0265-9