Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Feb 7, 2008; 14(5): 803-804
Published online Feb 7, 2008. doi: 10.3748/wjg.14.803
Circumferential mucosal dissection and esophageal perforation in a patient with eosinophilic esophagitis
Gennaro Liguori, Maurizio Cortale, Fabrizio Cimino, Michele Sozzi
Gennaro Liguori, Maurizio Cortale, Fabrizio Cimino, Department of General and Thoracic Surgery, Cattinara Hospital, Trieste 34149, Italy
Michele Sozzi, Service of Gastroenterology, Cattinara Hospital, Trieste 34149, Italy
Correspondence to: Gennaro Liguori, Department of General and Thoracic Surgery, Cattinara Hospital, Strada di Fiume 447, Trieste 34149, Italy. g.liguori@fmc.units.it
Telephone: +39-40-3994726
Fax: +39-40-3994373
Received: May 23, 2007
Revised: November 27, 2007
Published online: February 7, 2008
Abstract

A young man with a previous history of episodes of mild solid food dysphagia was admitted with a total dysphagia. The esophagogastroduodenoscopy (EGDS) showed an extensive disruption of mucosal layer with a cul-de-sac in the lower part of the esophagus. Soon after the procedure, the patient suffered from an acute chest pain and subsequent CT scan demonstrated an intramural circumferential dissection of thoracic esophagus, and a mediastinal emphysema. An emergency right thoracotomy was performed, followed by a total esophagectomy with esophagogastroplasty and jejunostomy. The histopathology confirmed that mucosal and submucosal layers were circumferentially detached from muscular wall and showed an eosinophilic infiltration of the whole organ with necrosis and erosions of mucosal, submucosal and muscular layers. The diagnosis was esophageal perforation in eosinophilic esophagitis.

Keywords: Thoracic surgery emergency; Esophageal perforation; Eosinophilic esophagitis; Esophageal mucosal dissection; Esophagus surgery