Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2022; 10(29): 10695-10700
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10695
Submucosal esophageal abscess evolving into intramural submucosal dissection: A case report
Yang Jiao, Yin-He Sikong, Ai-Jun Zhang, Xiu-Li Zuo, Pu-Yue Gao, Qing-Guo Ren, Ru-Yuan Li
Yang Jiao, Department of General Surgery, Shandong University of Qilu Hospital (Qingdao), Qingdao 266000, Shandong Province, China
Yin-He Sikong, Ai-Jun Zhang, Pu-Yue Gao, Ru-Yuan Li, Department of Gastroenterology, Shandong University of Qilu Hospital (Qingdao), Qingdao 266000, Shandong Province, China
Xiu-Li Zuo, Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan 250000, Shandong Province, China
Qing-Guo Ren, Department of Radiology, Shandong University of Qilu Hospital, Shandong University, Qingdao 266000, Shandong Province, China
Author contributions: Jiao Y wrote this article; Sikong YH and Gao PY managed this patient’s hospitalization; Ren QG was in charge of the imaging diagnosis; Zuo XL and Zhang AJ made the diagnosis and treatment plan; Li RY performed the operation of this patient.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ru-Yuan Li, MM, Attending Doctor, Department of Gastroenterology, Shandong University of Qilu Hospital (Qingdao), No. 758 Hefei Road, Shibei District, Qingdao 266000, Shandong Province, China. liruyuan163@163.com
Received: May 6, 2022
Peer-review started: May 6, 2022
First decision: June 8, 2022
Revised: June 28, 2022
Accepted: September 1, 2022
Article in press: September 1, 2022
Published online: October 16, 2022
Abstract
BACKGROUND

Here we report a rare case of submucosal esophageal abscess evolving into intramural submucosal dissection.

CASE SUMMARY

An 80-year-old woman was admitted to our emergency department with a chief complaint of dysphagia and fever. Laboratory tests showed mild leukocytosis and elevated C-reactive protein level. Computed tomography showed thickening of the esophageal wall. Upper endoscopy showed a laceration of the esophageal mucosa and a submucosal mass. Spontaneous drainage occurred, and we could see purulent exudate from the crevasse. We closed the laceration with endoscopic clips. The patient did not remember swallowing a foreign body; however, she ate crabs before the symptoms occurred. We prescribed the patient with antibiotic, and the symptoms were gradually relieved. Two months later, upper endoscopy showed that the laceration was healed, and the submucosal abscess disappeared. However, intramural esophageal dissection was formed. We performed endoscopic incision of the septum using dual-knife effectively.

CONCLUSION

In conclusion, we are the first to report the case of esophageal submucosal abscess evolving into intramural esophageal dissection. The significance of this case lies in clear presentation of the evolution process between two disorders. In addition, we recommend that endoscopic incision be considered as one of the routine therapeutic modalities of intramural esophageal dissection.

Keywords: Submucosal esophageal abscess, Intramural esophageal dissection, Endoscopic incision, Case report

Core Tip: We are the first to report the case of esophageal submucosal abscess developing into intramural dissection. The significance of this case lies in clear presentation of the evolution process between two disorders, and we demonstrated that esophageal submucosal abscess is one of the etiologies of intramural esophageal dissection, which is a rare entity.