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[Spontaneous esophageal perforation related to fungal esophagitis]
Abstract:
The authors give account of spontaneous esophageal perforation developed on the basis of fungal oesophagitis. The lesion of the lower third of the esophagus classified as grade 4. on Kodsi classification displayed the same picture as an advanced esophageal cancer. They review signs, symptoms and varieties in macroscopic appearance of esophageal candidiasis. They warn that in case of a spontaneous perforation of "malignant" esophageal tumor with no preceding signs the rare condition of fungal esophagitis must certainly be considered.
Insights
Spontaneous esophageal perforation can arise from fungal esophagitis, mimicking advanced esophageal cancer. This rare condition requires consideration in cases of sudden perforation without preceding signs.
Area of Science:
- Gastroenterology
- Mycology
- Pathology
Background:
- Esophageal perforation is a serious condition often associated with malignancy or iatrogenic causes.
- Fungal esophagitis, particularly Candida esophagitis, is increasingly recognized but rarely presents as a cause of spontaneous perforation.
Observation:
- A case of spontaneous esophageal perforation is presented, originating from fungal esophagitis.
- The esophageal lesion, located in the lower third and graded as Kodsi grade 4, exhibited macroscopic features resembling advanced esophageal cancer.
Findings:
- The study reviews the clinical signs, symptoms, and macroscopic variations of esophageal candidiasis.
- Esophageal candidiasis can present with findings that are indistinguishable from esophageal malignancy on initial inspection.
Implications:
- Clinicians should consider fungal esophagitis in the differential diagnosis of spontaneous esophageal perforation, especially when the presentation mimics malignancy.
- Early recognition of fungal esophagitis as a cause of perforation can guide appropriate antifungal therapy and management, potentially avoiding unnecessary aggressive surgical interventions for presumed cancer.