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Case Reports in Surgery
Volume 2017, Article ID 4086056, 4 pages
https://doi.org/10.1155/2017/4086056
Case Report

Spontaneous Intramural Oesophageal Haematoma in a Patient with Uncontrolled Hypertension: An Unusual Chest Pain Aetiology

Department of Upper Gastrointestinal Surgery, St. Thomas’ Hospital, Guy’s and St. Thomas’ Oesophago-Gastric Centre, London, UK

Correspondence should be addressed to Dionysios Dellaportas; moc.liamg@oidpalled

Received 9 September 2016; Revised 4 December 2016; Accepted 19 December 2016; Published 20 February 2017

Academic Editor: Brian H. H. Lang

Copyright © 2017 Samantha Cooray et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Spontaneous intramural oesophageal haematoma is a rare condition that usually occurs secondary to an acute or chronic coagulation disorder. The presenting complaint is often with retrosternal chest pain and most patients are initially investigated to exclude more common causes in the differential diagnosis, such as acute coronary syndromes. Severe life-threatening bleeding or perforation seldom, if ever, arises. Case Presentation. We present a case of spontaneous oesophageal haematoma which appears to have developed gradually in a 69-year-old female with uncontrolled hypertension and antiplatelet medication use. The diagnosis was made on computed tomography imaging and was further evaluated with upper gastrointestinal endoscopy. Management was conservative and a follow-up endoscopy two weeks later showed almost complete resolution of the lesion. Discussion. Spontaneous oesophageal haematomas are very rare and usually result in the separation of the mucosal layer from the underlying muscle, presenting with chest pain, haematemesis, and dysphagia. Usually the diagnosis is one of exclusion, based on computed tomography imaging and endoscopy. Conservative management is almost always successful.