"Spontaneous Intramural Esophageal Hematoma Associated with Uncontrolled Hypertension: Case Report and Review".

Introduction: Intramural esophageal hematoma (IEH) is a rare entity in the spectrum of esophageal injuries that often present with symptoms, such as acute chest pain, dysphagia and/or hematemesis. Herein, we present an interesting case of spontaneous IEH in a patient with uncontrolled hypertension, in the absence of established predisposing factors. Case Presentation: 61-years female, with a history of hypertension but no coagulopathy or anticoagulant/antiplatelet use, presented with sudden onset chest pain associated with complete dysphagia for 6 hours. She was found to have uncontrolled hypertension, with a blood pressure of 220/110 mmHg. She underwent computed tomography imaging of the chest followed by upper gastrointestinal endoscopy, which confirmed a diagnosis of spontaneous IEH. Conservative management and aggressive blood pressure control led to complete resolution of IEH within four weeks. Conclusion: This case highlights the importance of considering spontaneous IEH in the differential diagnosis of acute-onset chest pain with dysphagia in hypertensive patients, particularly in those with atypical presentations.