Dissecting intramural hematoma of the esophagus (DIHE) is a rare disorder of the esophagus that presents with chest pain..
Synonym: esophageal apoplexy
Pathology: spontaneous intramural hematoma, which may dissect along esophageal
Risk factors:
(1) coagulopathy, including thrombolysis
(2) hemodialysis
Clinical features:
(1) sudden onset of central chest and interscapular pain
(2) dysphagia
(3) odynophagia
(4) vomiting
(5) variable hematemesis
Imaging studies show a hematoma within the wall of the esophagus.
Complications:
(1) hemothorax
(2) massive esophageal hemorrhage
(3) pneumomediastinum
Exclusion: esophageal trauma
To read more or access our algorithms and calculators, please log in or register.
Specialty: Gastroenterology
