Spontaneous Oesophageal Intramural Haematoma: an Uncommon Condition in Two Patients
KK Cheng, S Lau
Hong Kong J Radiol 2015;18:227-32
DOI: 10.12809/hkjr1514257
Oesophageal intramural haematoma is an uncommon form of oesophageal injury. Oesophageal intramural haematoma can occur spontaneously without any preceding events. This report is of two patients who presented with haemoptysis and were incidentally found to have spontaneous oesophageal intramural haematoma by computed tomography. The diagnoses were confirmed by endoscopy and both patients were treated conservatively and had complete resolution confirmed by follow-up imaging and endoscopic examination. The typical clinical findings of central chest pain, dysphagia or odynophagia, and haematemesis, are non-specific and could mimic a wide variety of conditions. Correct diagnosis can be made with clinical history and characteristic computed tomography findings. Although spontaneous oesophageal intramural haematoma is uncommon and presentation with haemoptysis is not typical, radiologists and clinicians should not overlook this condition as a differential diagnosis.
中文摘要
自發性食道壁內血腫：兩名患者的罕見病症
鄭加勁、柳洵
食道壁內血腫是食道損傷的一種罕見形式。自發性食道壁內血腫發病前可無任何先兆。本文報告兩名因咯血就診，於電腦斷層掃描中偶然發現自發性食道壁內血腫，後經內鏡確診的病例。兩名病人均接受保守治療，並於隨訪影像及內鏡檢查證實完全康復。該病的典型臨床表現如胸痛、吞嚥困難或吞嚥痛、及嘔血不僅均屬非特異性，而且類似多種其他疾病的症狀。不過結合臨床病史和CT特徵性表現可作出正確診斷。雖然自發性食道壁內血腫很少見，咯血也非典型起病症狀，但放射科醫生和臨床醫生不應忽視將該病列為鑑別診斷之一。