Esophageal dissection after transesophageal echocardiography in a patient with Barrett's esophagus and long-term systemic steroid therapy.

摘要

A 47-year old man presented with coronary artery disease and severe mitral incompetence caused by prolapse of the posterior mitral valve leaflet. The patient suffered from dyspnea during exercise and occasional palpitations at rest. His past medical history was significant for obstructive pulmonary disease complicated by recurrent pulmonary infections, chronic adrenal gland insufficiency because of long-term treatment with systemic corticosteroids, and type-2 diabetes mellitus controlled with oral antidiabetics. Two years before hospital admission, an endoscopic evaluation revealed an axial hiatus hernia and Barrett's esophagus without dysplasia. The patient was asymptomatic under proton pump inhibitor therapy.