Intramural Esophageal Dissection: A Rare Cause of Acute Chest Pain after Percutaneous Coronary Intervention
Abstract
Intramural esophageal dissection is a condition that typically presents with chest pains and may be associated with hematemesis, odynophagia, and hematemesis. The role of antiplatelet/anticoagulant agents in the development of intramural esophageal hematoma is controversial. The management of intramural esophageal dissection is generally conservative with low mortality and morbidity. The case described here is a 66-year-old woman who presented with chest pains, odynophagia, and dysphagia 1 month after percutaneous coronary intervention while taking ASA (80 mg daily) and clopidogrel (75 mg daily) for dual antiplatelet therapy. The patient was diagnosed as intramural esophageal dissection and underwent successful conservative medical management. The relative contribution of dual antiplatelet therapy with ASA and clopidogrel after percutaneous coronary intervention in this case is, albeit uncertain, a possibility.
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2. Zimmer V, Lammert F. Clinical images: Multiple esophageal submucosal hematomas. CMAJ 2010;182:62.
3. Cullen SN, McIntyre AS. Dissecting intramural haematoma of the oesophagus. Eur J Gastroenterol Hepatol 2000;12:1151-1162.
4. Horan P, Drake M, Patterson RN, Cuthbert RJ, Carey D, Johnston SD. Acute onset dysphagia associated with an intramural oesophageal haematoma in acquired haemophilia. Eur J Gastroenterol Hepatol 2003;15:205-207.
5. Marks IN, Keet AD. Intramural rupture of the oesophagus. Br Med J 1968;3:536-537.
6. Geller A, Gostout CJ. Esophagogastric hematoma mimicking a malignant neoplasm: clinical manifestations, diagnosis, and treatment. Mayo Clin Proc 1998;73:342-345.
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8. Restrepo CS, Lemos DF, Ocazionez D, Moncada R, Gimenez CR. Intramural hematoma of the esophagus: a pictorial essay. Emerg Radiol 2008;15:13-22.
9. Biagi G, Cappelli G, Propersi L, Grossi A. Spontaneous intramural haematoma of the oesophagus. Thorax 1983;38:394-395.
10. Lin IT, Bair MJ, Chen HL, Wu CH. Pill-related esophageal intramural hematoma and dissection. Gastrointest Endosc 2010;72:432-433.
11. Ivekovic H, Ivekovic MP. Intramural esophageal hematoma: an unusual complication of endotracheal intubation. J Emerg Med 2013;44:e89-90.
12. Meulman N, Evans J, Watson A. Spontaneous intramural haematoma of the oesophagus: a report of three cases and review of the literature. Aust N Z J Surg 1994; 64:190-193.
13. Van Laethem JL, Devière J, Cremer M. Serial endoscopic findings of spontaneous intramural hematoma of the esophagus. Endoscopy 1997; 29:44-46.
14. Hiller N, Zagal I, Hadas-Halpern I. Spontaneous intramural hematoma of the esophagus. Am J Gastroenterol 1999; 94:2282-2284.
15. Horan P, Drake M, Patterson RN, Cuthbert RJ, Carey D, Johnston SD. Acute onset dysphagia associated with an intramural oesophageal haematoma in acquired haemophilia. Eur J Gastroenterol Hepatol 2003; 15:205-207.
16. Daubert MA, Jeremias A. The utility of troponin measurement to detect myocardial infarction: review of the current findings. Vasc Health Risk Manag 2010;6:691-699.
17. Ouatu-Lascar R, Bharadhwaj G, Triadafilopoulos G. Endoscopic appearance of esophageal hematomas. World J Gastroenterol 2000; 6:307-309.
18. Abbey P, Sharma R, Garg PK. Spontaneous intramural haematoma of the oesophagus: complete resolution on follow-up magnetic resonance imaging. Singapore Med J 2009;50:e318-320.
19. Meininger M, Bains M, Yusuf S, Gerdes H. Esophageal intramural hematoma: a painful condition that may mimic an esophageal mass. Gastrointest Endosc 2002;56:767-770.
20. Kamphuis AG, Baur CH, Freling NJ. Intramural hematoma of the esophagus: appearance on magnetic resonance imaging. Magn Reson Imaging 1995;13:1037-1042.
21. Kerr WF. Spontaneous intramural rupture and intramural haematoma of the oesophagus. Thorax 1980;35:890-897.
2. Zimmer V, Lammert F. Clinical images: Multiple esophageal submucosal hematomas. CMAJ 2010;182:62.
3. Cullen SN, McIntyre AS. Dissecting intramural haematoma of the oesophagus. Eur J Gastroenterol Hepatol 2000;12:1151-1162.
4. Horan P, Drake M, Patterson RN, Cuthbert RJ, Carey D, Johnston SD. Acute onset dysphagia associated with an intramural oesophageal haematoma in acquired haemophilia. Eur J Gastroenterol Hepatol 2003;15:205-207.
5. Marks IN, Keet AD. Intramural rupture of the oesophagus. Br Med J 1968;3:536-537.
6. Geller A, Gostout CJ. Esophagogastric hematoma mimicking a malignant neoplasm: clinical manifestations, diagnosis, and treatment. Mayo Clin Proc 1998;73:342-345.
7. Hagel J, Bicknell SG, Haniak W. Imaging management of spontaneous giant esophageal intramural hematoma. Can Assoc Radiol J 2007;58:76-78.
8. Restrepo CS, Lemos DF, Ocazionez D, Moncada R, Gimenez CR. Intramural hematoma of the esophagus: a pictorial essay. Emerg Radiol 2008;15:13-22.
9. Biagi G, Cappelli G, Propersi L, Grossi A. Spontaneous intramural haematoma of the oesophagus. Thorax 1983;38:394-395.
10. Lin IT, Bair MJ, Chen HL, Wu CH. Pill-related esophageal intramural hematoma and dissection. Gastrointest Endosc 2010;72:432-433.
11. Ivekovic H, Ivekovic MP. Intramural esophageal hematoma: an unusual complication of endotracheal intubation. J Emerg Med 2013;44:e89-90.
12. Meulman N, Evans J, Watson A. Spontaneous intramural haematoma of the oesophagus: a report of three cases and review of the literature. Aust N Z J Surg 1994; 64:190-193.
13. Van Laethem JL, Devière J, Cremer M. Serial endoscopic findings of spontaneous intramural hematoma of the esophagus. Endoscopy 1997; 29:44-46.
14. Hiller N, Zagal I, Hadas-Halpern I. Spontaneous intramural hematoma of the esophagus. Am J Gastroenterol 1999; 94:2282-2284.
15. Horan P, Drake M, Patterson RN, Cuthbert RJ, Carey D, Johnston SD. Acute onset dysphagia associated with an intramural oesophageal haematoma in acquired haemophilia. Eur J Gastroenterol Hepatol 2003; 15:205-207.
16. Daubert MA, Jeremias A. The utility of troponin measurement to detect myocardial infarction: review of the current findings. Vasc Health Risk Manag 2010;6:691-699.
17. Ouatu-Lascar R, Bharadhwaj G, Triadafilopoulos G. Endoscopic appearance of esophageal hematomas. World J Gastroenterol 2000; 6:307-309.
18. Abbey P, Sharma R, Garg PK. Spontaneous intramural haematoma of the oesophagus: complete resolution on follow-up magnetic resonance imaging. Singapore Med J 2009;50:e318-320.
19. Meininger M, Bains M, Yusuf S, Gerdes H. Esophageal intramural hematoma: a painful condition that may mimic an esophageal mass. Gastrointest Endosc 2002;56:767-770.
20. Kamphuis AG, Baur CH, Freling NJ. Intramural hematoma of the esophagus: appearance on magnetic resonance imaging. Magn Reson Imaging 1995;13:1037-1042.
21. Kerr WF. Spontaneous intramural rupture and intramural haematoma of the oesophagus. Thorax 1980;35:890-897.
| Files | ||
| Issue | Vol 14 No 3 (2019): J Teh Univ Heart Ctr | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/jthc.v14i3.1433 | |
| Keywords | ||
| Percutaneous coronary intervention Esophagus Dissection Chest pain | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Abdi S, Baianati MR, Momtahen M, Mohebbi B. Intramural Esophageal Dissection: A Rare Cause of Acute Chest Pain after Percutaneous Coronary Intervention. J Tehran Heart Cent. 2019;14(3):138-140.
