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一个不寻常的慢性咳病例:它是否超出了简单的胃食道逆流性疾病?
Grant Hughes1, Austin Reynolds2, Knogwan Yuenyongsagul3,4
1Family Medicine, Dignity Health East Valley, Gilbert, USA.
Cureus
|May 19, 2025
概括
慢性咳可能是食道癌的不寻常的早期症状,具有挑战性的诊断. 当常见的咳治疗方法失败时,扩大差异诊断至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
背景情况:
- 食道癌往往伴有失消,体重减轻或胸痛.
- 慢性咳是食道癌的不太常见但具有挑战性的初始症状.
- 在没有成像的情况下,将食道恶性瘤与喘或GERD等常见咳原因区分开来可能很困难.
研究的目的:
- 突出了慢性咳作为食道癌的初始症状所带来的诊断挑战.
- 强调在持续,无法解释的慢性咳的情况下进行广泛的差异诊断的重要性.
主要方法:
- 一个77岁的男性病例报告,有长期的慢性咳病史.
- 诊断工作包括过敏转诊,胃肠病学咨询和内镜与活检.
- 治疗包括化学辐射,然后是远端食道切除术.
主要成果:
- 这位患者最初因慢性咳而被诊断为过敏性鼻炎.
- 食道腺癌是在持续咳一年后被诊断出来的,随后出现了反流和胸痛.
- 患者在多模式治疗后实现了四年的缓解.
结论:
- 慢性咳可能是食道癌的罕见症状,模仿常见的呼吸道疾病.
- 医生应该对慢性咳保持广泛的差异诊断,特别是当初始治疗无效时.
- 及时和彻底的调查对于及时诊断和管理可能危及生命的疾病,如食道癌,至关重要.
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