Intramural esophageal dissection after trans-esophageal echocardiogram

Abstract

A 31-year-old man with history of eosinophilic esophagitis, maintained on topical fluticasone, was admitted with Staphylococcus aureus bacteremia. The patient had no dysphagia at presentation. He underwent trans-thoracic echocardiogram, which was inconclusive for vegetations. Trans-esophageal echocardiogram (TEE) was attempted, but was unsuccessful. At the third attempt to advance the 13mm probe beyond 30cm from the incisors, he developed chest pain followed by hematemesis. The procedure was terminated.