Eur J Cardiothorac Surg 1999;16:665-666
© 1999 Elsevier Science NL
Images in cardio-thoracic surgery |
Spontaneous esophageal dissection
Chiung-Lun Kao,
Jen-Ping Chang
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Rd., Niao Sung Hsiang, Kaohsiung Hsien, Taiwan ROC
Corresponding author. Tel.: +886-7-731-7123; fax: +886-7-731-8762
e-mail: sa11421{at}adm.cgmh.com.tw
A 55-year-old man was referred to our hospital for sore throat, chest pain, and low-grade fever. There was no previous history of vomiting, trauma, or food impaction. The esophagoscope failed to make the diagnosis. The magnetic resonance imaging examination demonstrated double rim enhancement over the mucosa and the muscular layers of the esophagus (Figs. 1 and 2). The esophagogram revealed a typical ‘double barrelled’ esophagus, which confirmed the diagnosis of esophageal dissection. Subsequently he was managed non-operatively and recovered uneventfully. At the 2 years follow-up visit, he was asymptomatic, but the defect still presented on the esophagogram with minimal regression as compared with previously consecutive esophagograms.
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Fig. 1. MR imaging of the chest, transverse view demonstrating double rim enhancement of the mucosa and the muscular layers of the esophagus. Arrowheads indicate the esophageal lesion.
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Fig. 2. MR imaging of the chest, Sagittal view demonstrating circumferential thickening (arrowheads) of the esophageal wall from the thoracic inlet to the E–C junction.
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Received May 24, 1999;
received in revised form August 16, 1999;
accepted September 22, 1999.
