Spontaneous Submucosal Dissection of the Esophagus: Report of 1 Case / 대한흉부외과학회지

ABSTRACT

A 55-year-old male was admitted to our hospital complaining of chest discomfort, dysphagia and severe pain on swallowing. Esophageal manometry showed that there was no relaxation of lower esophageal sphincter to swallowing. There was double barrelled esophagus or mucosal stripe appearance on esophagogram. Endoscopy revealed an appearance as if an esophago-tracheal fistula had been made at the level of the upper thoracic esophagus. Also, two slit-like mucosal tears was seen on the lower esophagus. There after, fasting and total parenteral nutrition for several weeks failed to bring about any changes in his symptoms. So, as treatment, primary closure of the upper opening of the false lummen was performed under general anesthesia. Soon after the surgical procedure, the patient's symptoms were improved except for mild dysphagia. He was discharged after oral intake had been juduciously commenced with fluids and soft diet subsequently. During follow-up in out-patient department, he had no specific symptoms including fever or dysphagia and massive dissection of the esophagus was improved on esophagogram. We report the experience of a case of spontaneous submucosal dissection of the esophagus which required conservative and surgical management.