Extensive spontaneous submucosal dissection of the esophagus: Long-term sequential endoscopic observation and treatment

Jung, Kee-Wook; Lee, Ok-Jae

doi:10.1067/mge.2002.121872

Cited by 15 publications

(20 citation statements)

References 17 publications

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“…In a case, a reported foreign body (a fish bone) caused esophageal mucosal dissection [4]. In patients with thrombocytopenia and use of anticoagulants, bleeding is frequently the first symptom of submucosal esophageal dissection [5]. Symptoms are sudden strong chest pain, swallowing disturbances, odynophagia after heavy drinking, and/or hyperphagia.…”

Section: Discussionmentioning

confidence: 99%

“…It is thought to be a detachment of the lower esophageal mucosal/submucosal layer from sudden elevation of intraesophageal pressure caused by vomiting [6]. In the literature, causes such as hematoma, aspirin ingestion, abnormal swallowing, or esophagomucosal abscess have been reported [2,5].…”

Section: Discussionmentioning

confidence: 99%

“…Conservative therapies include fasting with total parenteral nutrition and administration of PPIs and Alloid G [4,5,[8][9][10]13]. Surgical therapies [2,4,12,14], and endoscopic treatments such as cutting of the mucosal bridge using an endoscopic diathermy snare knife [3], have been recommended for recurrent or intractable disease [6].…”

Section: Discussionmentioning

confidence: 99%

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A case of spontaneous submucosal dissection of the esophagus

et al. 2011

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case of spontaneous submucosal dissection of the esophagus

et al. 2011

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“…ET has included photodynamic therapy (PDT), endoscopic mucosal resection (EMR), endoscopic submucosal dissection, radiofrequency ablation (RFA) and cryotherapy, as well as a variety of thermal treatments such as argon plasma coagulation (APC). [5][6][7][8][9] In theory, surveillance identifies those individuals who progress to cancer early, allowing intervention while it may still be curative and sparing those who never progress the risks of therapy. However, early cancers may be difficult to recognize endoscopically and may even be missed by standard biopsy protocols.…”

Section: Introductionmentioning

confidence: 99%

Endotherapy for Barrett’s Esophagus with High-Grade Dysplasia and Intramucosal Carcinoma

Schembre

2009

Journal of Gastrointestinal Surgery

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“…The esophageal mucosal layer can be separated or dissected from the submucosal level during endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD),1 submucosal endoscopy,2 or spontaneous esophageal submucosal dissection 3–7. Diagnostic esophagogastroduodenoscopy (EGD) is generally a very safe procedure 8.…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic esophageal submucosal dissection after attempted diagnostic gastroscopy (with videos)

Tang

Jazrawi

et al. 2008

The Laryngoscope

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Diagnostic esophagogastroduodenoscopy (EGD) is generally a very safe procedure. We report the first case of iatrogenic esophageal submucosal dissection after an attempted diagnostic gastroscopy in a patient with a small previously undiagnosed Zenker's diverticulum (ZD). After EGD, she developed severe dysphagia with the inability to swallow solids, liquids, and even her own saliva. On barium swallow study, there was a column of contrast below the upper esophageal sphincter, and this was misdiagnosed as a large ZD by the radiologist. The resultant stricture was successfully managed with endoscopic balloon dilatation under fluoroscopy with wire-guided cannulation. The ZD was treated with flexible endoscopic clip-assisted diverticulotomy. Iatrogenic submucosal dissection is a unique complication of upper endoscopy. Endoscopists, otolaryngologists, radiologists, and cardiothoracic surgeons should be aware of this condition and prepare to manage it appropriately. If the patient is stable and the possibility of perforation is small, conservative and supportive care can be tried first. A surgical gastrostomy tube can be placed for enteral feeding. In patients with ZD, ZD recognition and gentle manipulation is strongly recommended during esophageal intubation.

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Extensive spontaneous submucosal dissection of the esophagus: Long-term sequential endoscopic observation and treatment

Cited by 15 publications

References 17 publications

A case of spontaneous submucosal dissection of the esophagus

A case of spontaneous submucosal dissection of the esophagus

Endotherapy for Barrett’s Esophagus with High-Grade Dysplasia and Intramucosal Carcinoma

Iatrogenic esophageal submucosal dissection after attempted diagnostic gastroscopy (with videos)

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