Clinical Presentation
A 53-year-old woman with a past medical history of anticoagulation therapy for pulmonary embolism and deep vein thrombosis, now presenting with acute chest pain.
Imaging Findings
(A–C) Contrast-enhanced computed tomography (CT) of the chest: axial images demonstrate a large, well-defined hyperdensity throughout the entire length of the esophageal wall, eccentrically located and displacing the lumen anteriorly and to the right (arrows).
Differential Diagnosis
• Intramural hematoma of the esophagus (IHE): Acute IHE may present as a hyperdense collection located either concentrically or eccentrically in the esophageal wall.
• Esophageal tumor:
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