DISSECTING INTRAMURAL HEMATOMA OF THE ESOPHAGUS

The largest series of patients (n=10) with dissecting intramural haema toma of the oesophagus is described. The typical features, chest pain with odynophagia or dysphagia and minor haematemesis are usually prese nt but not always elicited at presentation. If elicited, these symptom s should suggest the diagnosis and avoid mistaken attribution to a car diac origin for the pain. Precipitating factors such as a forced Valsa lva manoeuvre cannot be identified in at least half the cases. Early e ndoscopy is safe, and confirms the diagnosis when an haematoma within the oesophageal wall or the later appearances of a longitudinal ulcer are seen. Dissecting intramural haematoma of the oesophagus has an exc ellent prognosis when managed conservatively.