Endoscopic injection sclerotherapy is widely used as treatment for bleeding esophageal varices. Esophageal intramural hematoma is a rare complication following endoscopic injection sclerotherapy. Patients present with pain and dysphagia due to esophageal obstruction. We present the first reported case of respiratory failure resulting from an intramural hematoma causing posterior tracheobronchial compression. Although patients with alcoholic cirrhosis and bleeding varices requiring respiratory support generally have a poor prognosis this may be an occasion when ventilatory support may be expected to be easily withdrawn after hematoma resolution.
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