A Case of Intramural Hematoma of the Esophagus Mimicking Acute Coronary Syndrome

• Main Authors: Dae Gon Ryu, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Dong Il Jeong, Wan Chul Kim, Jae Gyu Shin, Tae Won Lim
• Format: Article
• Language: English
• Published: Jin Publishing & Printing Co. 2017-04-01
• Series: The Korean Journal of Gastroenterology
• Subjects: Hematoma; Esophagus; Acute coronary syndrome
• Online Access: http://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2017.69.4.239

Intramural hematoma of the esophagus is a rare condition that can be spontaneous or secondary to trauma, toxic ingestion, or intervention. If it is the spontaneous type, it usually presents initially with epigastric pain, hematemesis or dysphagia. We present a case of intramural hematoma of the esophagus mimicking acute coronary syndrome. A 63-year-old man presented with severe acute chest pain. He has four coronary stents that were inserted five years ago, from a different hospital, and is on dual antiplatelet agents. Coronary angiography was performed immediately under the suspicion of acute coronary syndrome, and we found that there was no obvious clogging of the coronary arteries. Next, chest computed tomography was performed due to suspected aortic dissection, and the result was also negative. Four days later, endoscopy was performed and intramural hematoma covered with large ulcers was diagnosed.