Intramural haematoma of the oesophagus

Intramural haematoma of the oesophagus (IHO) is a rare, benign condition presenting as acute chest pain, dysphagia and haematemesis, secondary to a haematoma within the submucosal layer of the oesophagus. Here we present three patients (1 male and 2 female, mean age 68 years). Upper endoscopy, computed tomography (CT) scan and Gastrografin swallow were performed for diagnosis. The patients were managed conservatively. Repeat endoscopy at 1 month revealed complete resolution of the haematoma. A review of literature demonstrates IHO is twice as common in females with mean age of 61.8 years (range 20–92 years). Majority of cases were successfully managed conservatively and discharged on day 8 (range 7–15 days). Only two required surgery. Our experience and review of the literature demonstrate IHO has excellent prognosis with conservative treatment. Misdiagnosis and incorrect treatment as Boerhaave’s syndrome, a cardiac event or a pulmonary pathology could lead to worsening of the clinical condition.