An 83-year-old woman, under treatment with acetylsal-icylicacid as primary prevention for heart disease andhemodynamicallystable, was admitted to our hospitalafter 2 episodes of hematemesis. Upper gastrointestinalendoscopy revealed a linear violet mass partially occupy-ing the esophageal lumen at the esophagogastric junction(Fig. 1). Acontrast-enhanced chest computed tomogra-phy scan identified concentric thickening of the upper andmiddlethirds of the esophagus associated with a dilatedanomalous vessel in the muscle wall of the middle thirdofthe esophagus (Fig. 2). Contrast medium extravasationinthe muscle layer of the middle third of the esophagussecondaryto active bleeding was shown in the late arterialphaseof the study (Fig. 3). Upper gastrointestinal endoscopywas repeated 3 days after the initial presentation, reveal-ingmucosal dissection and tear in the middle third of theesophagus(Fig. 4). Dissecting hematoma of the esophageal.
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