食道內壁剝離臨床上較為少見，主要是在食道黏膜層及黏膜下層之間產生剝離，但未造成穿孔。食道內壁剝離通常與快速增加食道內壓力有關，大多發生於血液凝固有問題者。我們報告一例80歲女性病患，有慢性腎衰竭及高血壓之病史，住院後開始接受洗腎，且在住院期間突然發生吐血及胸部不適之情形，經胃鏡檢查發現在胃幽門及體部有多處潰瘍病灶，在十二指腸球部有一活動性潰瘍合併出血，當時予以內視鏡注射止血。另外在食道下段發現有一處剝離之黏膜。之後經由靜脈注射氫離子幫浦阻斷劑、禁食以靜脈輸液成功治療此病患。三個月後，胃鏡追蹤檢查發現十二指腸球部有一處潰瘍結疤，而食道及胃則正常。

Intramural esophageal dissection is a rare but well described condition that is characterized by a laceration between the esophageal mucosa and submucosa but without perforation. It is usually associated with a rapid increase in intraesophageal pressure, especially in the presence of coagulation disorder. Intramural esophageal dissection revealed by an upper gastrointestinal endoscopy was reported in a uremic case with sudden onset of hematemesis and anterior chest discomfort during admission. An active ulcer with bleeding in the duodenal bulb and multiple small ulcerations in the antrum and corpus of the stomach were also noted and immediately treated by injection therapy for duodenal bleeding. The patient was discharged completely asymptomatic. Three months later, follow-up upper endoscopy showed a healed scar in the duodenal bulb. The esophagus and the stomach were normal.