Esophageal emergencies: another important cause of acute chest pain

Abstract

A variety of esophageal pathologies can present emergently with a chief complaint of acute chest pain. Computed tomography (CT) is often the first line of imaging in esophageal emergencies and provides useful information—even without an initial suspicion—when used in conjunction with other imaging modalities such as esophagography and direct visualization. We review various urgent and emergent esophageal disease entities which may manifest as acute chest pain, with an emphasis on CT and ancillary imaging appearances, while discussing management according to their emergency. Radiologists should be familiar with the imaging findings of these esophageal emergencies in order to provide an accurate diagnosis and recommend timely and appropriate management.

Life-threatening bleeding from dissecting Intramural Hematoma of Esophagus (IHE) treated by trans arterial embolization.

“…DIHE should be considered in differential diagnosis of acute chest pain. It may be indistinguishable clinically from acute coronary or aortic conditions [10] . CT may help to detect DIHE or acute aortic syndrome spectrum.…”