Large Esophageal Intramural Hematoma After Solid Food Ingestion in a Patient Without Identifiable Inherited or Acquired Coagulopathy

We present the case of an elderly man without any significant medical history and not on any anticoagulant or antiplatelet therapy who presented with severe epigastric abdominal and substernal chest pain shortly after eating a baguette. He was found to have a large 15 cm dissecting intramural hematoma of the esophagus. He was managed conservatively with proton pump inhibitors. He remained stable throughout his hospitalization without evidence of an acute blood loss anemia and was discharged home. Repeat esophagogastroduodenoscopy 8 weeks after discharge showed a 5 mm scar with complete resolution of the dissecting intramural hematoma of the esophagus.