Spontaneous esophageal intramural hematoma in a young man wrongly diagnosed as achalasia

Intramural hematoma of the esophagus is a rare but well described type of acute injury of the esophageal wall and it is more frequently being recognized throughout the world. Patients usually present with acute retrosternal or epigastric pain, minor hematemesis and dysphagia. The condition is mostly seen in women with abnormal coagulation and it can either occur spontaneous or induced by trauma or transesophageal procedures. It is associated with food impaction and vomiting. Esophageal intramural hematoma has also been reported in young and healthy patients. Case reports with coexisting achalasia are limited. Management is conservative and its course is benign.