Restricted accessCase reportFirst published online 2015-02
First Successful Treatment of a Circumferential Intramural Esophageal Dissection with Perforation in a Patient with Eosinophilic Esophagitis Using a Partially Covered Self-Expandable Metal Stent
Intramural esophageal dissection (IED) is a rare disease characterized by a partial (PIED) or circumferential (CIED) mucosal rupture. Whereas PIED responds well to nonoperative treatment, complicated courses have been reported necessitating surgery, up to the point of esophagectomy despite complex endoscopic interventions, in CIED. We report the first case of an iatrogenic CIED with perforation in a young patient with underlying eosinophilic esophagitis treated successfully by endoscopy alone, using a partially covered self-expandable metal stent.
KimSH, LeeSO. Circumferential intramural esophageal dissection successfully treated by endoscopic procedure and metal stent insertion. J Gastroenterol, 2005; 40:1065–1069.
3.
BenattaMA, GrimaudJC, KaciM, DesjeuxA, BaghdadiM, LoumiA. Intramural esophageal dissection due to pharyngeal abscess treated by endoscopic esophageal transection: A case report. Gastroenterol Clin Biol, 2010; 34:329–331.
4.
LiguoriG, CortaleM, CiminoF, SozziM. Circumferential mucosal dissection and esophageal perforation in a patient with eosinophilic esophagitis. World J Gastroenterol, 2008; 14:803–804.
5.
WangS, RuanZ, LiuF, HuangH, ZhengJ, SongK. A rare case of circumferential intramural dissection of thoracic esophagus with contained esophageal perforation. Chin Med J (Engl), 2011; 124:3433–3435.
6.
ZhuRY, LawTT, TongD, TamG, LawS. Spontaneous circumferential intramural esophageal dissection complicated with esophageal perforation and esophageal-pleural fistula: A case report and literature review. Dis Esophagus, 2014March6 [Epub ahead of print]. doi: 10.1111/dote.12200.
7.
van RhijnBD, CurversWL, BergmanJJ, VerheijJ, BredenoordAJ. Esophageal perforation during endoscopic removal of food impaction in eosinophilic esophagitis: Stent well spent?. Endoscopy, 2014; 46:E193–E194.
8.
FischerA, BauschD, Richter-SchragHJ. Use of a specially designed partially covered self-expandable metal stent (PSEMS) with a 40-mm diameter for the treatment of upper gastrointestinal suture or staple line leaks in 11 cases. Surg Endosc, 2013; 27:642–647.
