Intramural haematoma of the esophagus: multimodality imaging findings and clinical triad.

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Acta Clinica Belgica Pub Date : 2014-10-01 Epub Date: 2014-07-14 DOI:10.1179/2295333714Y.0000000044
Q Wang, Y-H Juan, X Zhong
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引用次数: 2

Abstract

Intramural haematoma of the esophagus (IHE) is an uncommon clinical condition, which can mimic other cardiothoracic emergencies in both clinical and imaging perspectives. We presented the case of a 54-year-old female who presented to the emergency department with a clinical triad of retrosternal chest pain, odynophagia, and haematemesis for 3 days. Multi-detector computed tomography (MDCT) revealed long-segmental, well-defined, isodense mass in postero-lateral wall of esophagus with smooth arc-shaped indentation into the lumen and no obvious enhancement after IV contrast administration. The preserved fat plane between the thickened esophagus and the aorta allows exclusion of aortic dissection. Subsequent esophagogram and endoscopy confirmed the finding of IHE and thus, patient was successfully treated with conservative treatment and discharged uneventfully. Owing to the presence of clinical and image mimickers of IHE, the recognition of clinical triad of retrosternal pain, odynophagia, and haematemesis, and the typical MDCT and esophagographic presentation of submucosal haematoma are important in avoiding misdiagnosis with inappropriate treatment.

食管壁内血肿:多模态影像学表现和临床三联征。
食管壁内血肿(IHE)是一种罕见的临床疾病,它可以在临床和影像学方面模仿其他心胸急症。我们提出的情况下,54岁的女性谁提出了临床三联症胸骨后胸痛,痛饮,并吐血3天急诊科。多探测器计算机断层扫描(MDCT)显示食管后侧壁长节段、边界清晰、等密度肿块,平滑弧形凹陷进入管腔,静脉注射造影剂后无明显强化。在增厚的食管和主动脉之间保存的脂肪层可以排除主动脉夹层。随后的食管造影和内窥镜检查证实了IHE的发现,因此,患者成功地接受了保守治疗并平安无事地出院。由于IHE的临床和影像学模拟者的存在,认识胸骨后疼痛、咽痛和呕血的临床三联征,以及粘膜下血肿的典型MDCT和食管造影表现,对于避免误诊和不适当的治疗是重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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