Esophageal Hematoma

Excerpt

The esophagus is an approximately 25-cm muscular tube that connects the pharynx to the stomach. Histologically, it consists of several layers—the innermost mucosal layer, the submucosal layer (which connects the mucosa to the muscular layer), the outer muscular layer, and the adventitial layers. The submucosal layer contains blood vessels, the Meissner nerve plexus, and the esophageal glands.

Intramural hematoma of the esophagus, also known as dissecting intramural hematoma, is a rare manifestation of acute mucosal and submucosal injuries resulting in an interlayer blood collection. The condition can occur spontaneously or secondary to trauma from a foreign body, ingestion of toxic substances, or iatrogenic interventions. Patients may present with symptoms that mimic other acute cardiopulmonary diseases. The classic triad of symptoms associated with intramural hematoma of the esophagus includes acute chest pain, odynophagia or dysphagia, and hematemesis. Prognosis is usually excellent with proper diagnosis and management.