The esophagus is approximately 25-centimeter muscular tube that connects the pharynx to the stomach. Histologically it comprises of innermost mucosal layer, submucosal layer, muscular, and adventitial layer. submucosal layer. The second layer submucosa which connects the mucosal and muscular layer contains blood vessels, Meissner nerve plexus, and esophageal glands. Intramural hematoma of the esophagus (IHE) or dissecting intramural hematoma is a very rare manifestation of acute mucosal and submucosal injuries resulting in an interlayer collection of blood. IHE can be spontaneous and secondary to trauma with foreign body, toxic substance ingestion, or iatrogenic intervention related. Patients with IHE can present with symptoms mimicking other acute cardiopulmonary diseases. Classic triad associated with IHE is acute chest pain, odynophagia or dysphagia, and hematemesis. Usually, IHE is a very rare and benign condition. Prognosis is usually excellent with proper diagnosis and management.
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