Intramural hematoma of the esophagus: unusual complication of variceal sclerotherapy

Intramural haematoma of the oesophagus presenting as an unusual complication of endotracheal intubation

Intramural haematoma of the oesophagus is an uncommon and under-recognized condition. It may mimic other causes of chest pain, haematemesis, or dysphagia, and hence pose a diagnostic challenge. We report a case of an unusual presentation of intramural haematoma of the oesophagus occurring as a presumed complication of endotracheal intubation. It was disguised as acute onset post-operative chest pain, and resolved with conservative management. Awareness of this uncommon complication is important to allow rapid and timely diagnosis and management. We review the literature, causes and imaging features of this condition.

Mechanical Tracheal Obstruction Due to an Intramural Esophageal Hematoma following Endoscopic Variceal Sclerotherapy

Endoscopic injection sclerotherapy is widely used as treatment for bleeding esophageal varices. Esophageal intramural hematoma is a rare complication following endoscopic injection sclerotherapy. Patients present with pain and dysphagia due to esophageal obstruction. We present the first reported case of respiratory failure resulting from an intramural hematoma causing posterior tracheobronchial compression. Although patients with alcoholic cirrhosis and bleeding varices requiring respiratory support generally have a poor prognosis this may be an occasion when ventilatory support may be expected to be easily withdrawn after hematoma resolution.

Esophageal apoplexy: case report, review, and comparison with other esophageal disorders

Esophageal injuries are potentially serious disorders requiring prompt recognition and management. In addition to the well-recognized Mallory-Weiss and Boerhaave's syndromes, there exists a condition of spontaneous intramural esophageal hemorrhage: esophageal apoplexy. A case of esophageal apoplexy is presented as well as an evaluation of clinical presentations based on a collected review of the 66 cases previously reported. In addition, esophageal apoplexy is contrasted with the Mallory-Weiss and Boerhaave's syndromes, focusing on distinguishing attributes of utility to the emergency practitioner.

Endoscopic esophageal mucosal resection using a transparent tube

Generally, it is considered technically impossible to perform an extensive mucosal resection of the esophagus using endoscopy. We have developed a new method of endoscopic esophageal mucosal resection using a transparent tube (EMRT). With this technique, any amount and any part of the esophageal mucosa can be safely and easily resected. After an experimental study, EMRT was performed in 11 patients and there were no major complications. Near-total circumferential resection of the mucosa was possible, and the surface of the esophageal muscle layer (non-bleeding resection layer) was left intact. We performed this technique on a patient with a mucosal cancer of the esophagus, and succeeded in resecting the lesion during a short course of treatment. We conclude that EMRT is of value in the endoscopic treatment of early-stage esophageal cancer.

Intramural hematoma of the esophagus: unusual complication of esophageal variceal sclerotherapy

The authors report a case of esophageal hematoma in a 35-year-old man after esophageal variceal sclerotherapy with intravariceal injection of 5% ethanolamine oleate. A huge submucosal hematoma of the esophageal wall was demonstrated endoscopically and radiologically. Resolution occurred spontaneously after conservative treatment.