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

Abstract

Esophageal submucosal dissection is the most rarely reported of the 3 types of acute esophageal injury, which include the Mallory-Weiss and Boerhaave's syndromes. Although its etiology is controversial, the treatment and prognosis for esophageal submucosal dissection are the same as for the Mallory-Weiss syndrome. 1 Steadman C Kerlin P Crimmins F Bell J Robinson D Dorrington L et al. Spontaneous intramural rupture of the oesophagus. Gut. 1990; 31: 845-849 Crossref PubMed Scopus (62) Google Scholar , 2 Ho CL Young TH Yu CY Chao YC Intramural hematoma of the esophagus: ED diagnosis and treatment. Am J Emerg Med. 1997; 15: 322-323 Abstract Full Text PDF PubMed Scopus (13) Google Scholar , 3 Mion F Bernard G Valette PJ Lambert R Spontaneous intramural hematoma of esophagus. Gastrointest Endosc. 1978; 24: 172-174 Abstract Full Text PDF PubMed Scopus (28) Google Scholar , 4 Walts HD Postemetic hematoma: a varient of the Mallory-Weiss syndrome. Am J Surg. 1976; 132: 320-321 Abstract Full Text PDF PubMed Scopus (17) Google Scholar Conservative management is usually successful and prognosis is excellent. However, treatment appears to depend on the extent of submucosal dissection, and close follow-up is needed in cases requiring prolonged periods of time for complete healing. Serial endoscopic findings and clinical data on the course of esophageal submucosal dissection have not been reported. This is a description of the sequential endoscopic findings, sequelae, and treatment of a patient with extensive esophageal submucosal dissection.