Journal of Clinical Case Reports

Iatrogenic Full-Length Intramural Esophageal Dissection Associated with Pneumomediastinum after Attempted Diagnostic Gastroscopy

Abstract

Chin-Ho Lee, Wen Pin Chen, Yu-Min Feng and Pei-Yu Huang

Upper gastrointestinal endoscopy is a usually safe procedure. Intramural Esophageal Dissection (IED) is a rare disorder often due to the abrupt increased intraesophageal pressure after given the existence of mucosal tear. We present an extremely rare case of iatrogenic IED complicated with pneumomediastinum after a failed gastroscopy for healthy person. Reformatted computed tomographic images successfully established the diagnosis by means of the esophageal double lumen as full extent of intervening mucosal flap and mediastinal air. The patient got improvement following appropriate conservative management. Our case adds support of the hypothesis of gas diffusion across the muscular layers of the esophagus rather than real defect