Abstract
An 84-year-old woman receiving medication for Parkinson's disease and dementia was brought to our hospital complaining of anterior chest pain and dysphagia. She wandered around the house and fell backwards on the previous night. Emergency enhanced computed tomography (CT) revealed a giant spheroid mass (4×4.5×12 cm) in the posterior mediastinum along the esophagus. The patient was suspected to have intramural hematoma of the esophagus and was treated conservatively. Magnetic resonance imaging (MRI) on hospital day 3 revealed a low-signal, large, spheroid mass in the posterior mediastinum containing sporadic high signals on T1-weighted imaging. Endoscopic examination on hospital day 4 revealed a dark-red submucosal mass protruding over three-quarters of the esophageal lumen in the middle portion of the esophagus.
Subsequent CT on hospital day 11 showed marked reduction of the lesion, and esophageal endoscopy on hospital day 14 showed reduction of the submucosal mass and the appearance of a longitudinal ulcer. Because of improving dysphagia, she was discharged on the 22nd day after admission. Follow-up endoscopy performed one month from onset showed nearly normal mucosa and luminal cavity. We report a rare case of intramural hematoma of the esophagus caused by trauma.
