Endoscopic and radiological features of intramural esophageal dissection

A 41-year-old woman was admitted to our hospital complaining of chest pain, dysphagia, and odynophagia after an upper respiratory tract infection and nasogastric tube insertion. An upper endoscopy showed a large submucosal bu lge along the posterior wall from the upper esophagus with mucosal tears an d bridge formation, extending down to the lower esophagus. A barium esophag ogram revealed a "double-barreled" esophagus, and chest computed tomography (CT) scan showed eccentric thickening of the esophageal wall. The diagnosi s of intramural esophageal dissection OED) was made and the patient was man aged conservatively with nothing by mouth and intravenous hydration, The cl inical course was uneventful; the patient was discharged later and up to th e time of writing has been completely asymptomatic, with normal swallowing function.