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Esophageal laceration with intramural dissection mimics esophageal perforation

^a Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, #160, Sec. 3, Taichung Gung Rd., Taichung, Taiwan
^b Chung Shan Medical University, Taichung, Taiwan
^c China Medical University, Taichung, Taiwan
^d National Yang-Ming University, Taipei, Taiwan

*Corresponding author. Tel.: +886 4 23592525 ext. 5045; fax: +886 4 23741283.

E-mail address: hjy{at}vghtc.gov.tw (J.-Y. Hsia).

Esophageal laceration with intramural dissection is a rare type of injury but without perforation. It is difficult to differentiate from esophageal perforation at presentation time. We report the case of a 46-year-old man who was admitted to our hospital complaining of progressive chest pain, dysphagia, and odynophagia after swallowing a fish bone three days prior to admission. Esophagoscopy revealed a deep longitudinal laceration with pus discharge in the esophagus. Computed tomography of the chest revealed low posterior mediastinal abscess formation. Surgery was performed under the impression of esophageal perforation. The definite diagnosis was esophageal laceration with intramural dissection.

Key Words: Esophageal laceration; Intramural dissection; Perforation