title: [A case of conservatively resolved intramural esophageal dissection combined with pneumomediastinum].
abstract: Intramural esophageal dissection (IED) is a rare form of esophageal injury. We report a rare case of spontaneous IED complicated with pneumomediastinum and successfully improved by conservative management. A 46-year-old man presented to the emergency department with chest pain and hematemesis. The endoscopic diagnosis was suspicious of IED. Chest CT scan performed to rule out complication noted IED combined with pneumomediastinum. He was managed conservatively with nil per oral, intravenous antibiotics and parenteral nutrition. Follow up study after 2 weeks later showed near complete resolution of IED. IED should be included in the differential diagnosis for unexplained acute chest pain, especially, associated with dysphagia and hematemesis. IED with pneumomediastinum or mediastinitis require prompt surgery. So far, there is no case report of IED combined with pneumomediastinum which resolved without surgical treatment. In this case, IED combined with pneumomediastinum has improved by conservative management, so we present a case report.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: In Hye
authors.initials: IH
authors.lastname: Cha
authors.forename: Jin Nam
authors.initials: JN
authors.lastname: Kim
authors.forename: Sun Ok
authors.initials: SO
authors.lastname: Kwon
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Myoung Ki
authors.initials: MK
authors.lastname: Oh
authors.forename: Soo Hyung
authors.initials: SH
authors.lastname: Ryu
authors.forename: You Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Jeong Seop
authors.initials: JS
authors.lastname: Moon
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004935:Esophageal Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005773:Gastroscopy; D006396:Hematemesis / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents