Intramural esophageal dissection: CT imaging features

Spontaneous Intramural Full-Length Dissection of Esophagus Treated with Surgical Intervention: Multidetector CT Diagnosis with Multiplanar Reformations and Virtual Endoscopic Display

“…However, most cases of IED are attributable to iatrogenic causes, such as standard endoscopy and endoscopic intervention ( 6 ). Spontaneous IED occurs commonly in elderly women ( 1 ), in those who have bleeding tendency due to underlying liver cirrhosis ( 4 ), and in patients on anticoagulant agent or who have an inherent coagulopathy ( 6 ). Patients usually present with acute chest pain, odynophagia, dysphagia, and (rarely) hematemesis.…”

“…Patients usually present with acute chest pain, odynophagia, dysphagia, and (rarely) hematemesis. Thus, their symptoms may occasionally mimic those of acute myocardial infarction or aortic dissection ( 1 ).…”

“…CT can be used to evaluate the full extent of the lesion through MPR images, and helps to differentiate IED from acute cardiovascular and other esophageal diseases ( 6 ). CT of IED shows an eccentric true lumen surrounded by a thickened wall that is separated from a false lumen by a thin mucosal flap ( 1 , 8 ). In most cases of IED, the false esophageal lumen is located posterior to the true lumen ( 6 ).…”

“…Spontaneous intramural esophageal dissection (IED) is a rare disorder characterized by sudden onset of severe retrosternal chest pain, odynophagia and dysphagia caused by transverse and longitudinal separation of the mucosal and submucosal layers of the esophageal wall, with or without perforation ( 1 , 2 ). The etiology of spontaneous IED remains uncertain and conservative management is typically thought to be adequate in uncomplicated cases.…”

Intramural esophageal dissection after endoscopy: a case report in a hypopharyngeal cancer patient treated with concurrent chemoradiotherapy

“…Intramural esophageal dissection (IED) is a rare disorder characterized by a separation of the mucosa and/ or submucosa from deeper muscular layers of the esophagus, with or without perforation. [1][2][3] The causes of IED include mucosal injuries from ingestion of sharp foreign body, abrupt increase in intraesophageal pressure such as forceful vomiting, anticoagulation therapy or inherent coagulopathy, and iatrogenic instrumentation including endoscopy. Among them, iatrogenic instrumentation such as endoscopy is probable the most important risk factor.…”