Esophageal intramural hematoma: An unusual cause of acute onset chest pain

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dc.contributor.authorUmapathy, Ven_US
dc.contributor.authorKulandaivelu, A.en_US
dc.date.accessioned2025-08-13T11:20:42Z
dc.date.available2025-08-13T11:20:42Z
dc.date.issued2025-06
dc.description.abstractAn elderly lady in her mid-70 s who is known to have coronary artery disease for which she was on dual antiplatelet therapy, presented with acute onset chest pain and dysphagia. The cardiac evaluation was unremarkable. Esophagogastroduodenoscopy (EGD) showed a large intramural hematoma in the esophagus, causing luminal narrowing. A diagnosis of esophageal intramural hematoma secondary to antiplatelets was made based on the findings of Gastrografin swallow, EGD, and contrast-enhanced computed tomography of the thorax along with the history of taking dual antiplatelets. Antiplatelets were subsequently stopped. She was managed in the critical care unit with intravenous fluids, pantoprazole infusion, empirical antibiotics, fentanyl infusion, and total parenteral nutrition. The relook EGD showed a resolving hematoma. She was maintained on intravenous pantoprazole, allowed to take oral feeds gradually, and was subsequently discharged. To conclude, intramural hematoma of the esophagus can present with acute chest pain and dysphagia. Careful history taking, especially the drug history and appropriate investigations, are pivotal as there are high chances of misdiagnosis and unwanted anticoagulant therapy.en_US
dc.identifier.affiliationsResident, Department of Internal Medicine, Kauvery Hospital, Trichy, Tamil Nadu, Indiaen_US
dc.identifier.affiliationsConsultant Medical Gastroenterologist, Department of Medical Gastroenterology, Kauvery Hospital, Trichy, Tamil Nadu, Indiaen_US
dc.identifier.citationUmapathy V, Kulandaivelu A.. Esophageal intramural hematoma: An unusual cause of acute onset chest pain . Indian Journal of Case Reports. 2025 Jun; 11(6): 248-250en_US
dc.identifier.issn2454-1303
dc.identifier.issn2454-129X
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/253731
dc.languageenen_US
dc.publisherMansa STM Publishersen_US
dc.relation.issuenumber6en_US
dc.relation.volume11en_US
dc.source.urihttps://doi.org/10.32677/ijcr.v11i6.5027en_US
dc.subjectAnticoagulanten_US
dc.subjectAntiplateleten_US
dc.subjectChest painen_US
dc.subjectDysphagiaen_US
dc.subjectEsophagogastroduodenoscopyen_US
dc.subjectEsophagusen_US
dc.subjectGastrografin swallowen_US
dc.subjectIntramural hematomaen_US
dc.subjectOdynophagiaen_US
dc.titleEsophageal intramural hematoma: An unusual cause of acute onset chest painen_US
dc.typeJournal Articleen_US
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