一个由未诊断的埃索诺菲尔性食道炎引起的食道孔隙病例
Reyleen R Loreto1, Yesenia Gonzalez1, Antoine Khoudari1
1Internal Medicine, Baycare Health System, Tampa, USA.
Cureus
|December 8, 2025
概括
性食道炎 (EOE) 可以导致严重的并发症,如食道穿孔,即使没有典型的症状. 早期诊断和治疗对于预防GERD或异常食道问题患者的危及生命的结果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 病理学 病理学 病理学
背景情况:
- 生性食道炎 (EoE) 是一种慢性免疫介导的食道疾病,患病率越来越高.
- 这种EoE可以无症状出现,直到出现严重的并发症,如食道穿孔.
- 胃食道逆流性疾病 (GERD) 和反应性呼吸道疾病是常见的并发症.
研究的目的:
- 为了呈现一种自发食道穿孔的情况,这是未被诊断的EOE的次要原因.
- 要强调在患有非典型食道症状或GERD的患者中考虑EoE的重要性.
- 强调早期诊断和多学科管理的必要性.
主要方法:
- 诊断成像 (CT扫描) 以确定食道穿孔和肺中.
- 消化管胃管腺镜 (EGD) 用于可视化消化管异常并获得活检.
- 消化管活检的组织病理学检查,以量化埃索诺菲尔透.
主要成果:
- 一名38岁的男性呈现急性胸痛和呼吸障碍,诊断为食道中间穿孔和肺中.
- EGD揭示了食道扩张,线性,活检显示高达52个乙酸/HPF,证实了EoE.
- 包括内镜/手术修复和真空辅助关闭在内的多学科治疗导致了完全康复.
结论:
- 未被诊断的EoE可能导致危及生命的食道穿孔.
- 在患有GERD或异常食道症状的患者中,EoE的高怀疑指数是必要的.
- 及时诊断和全面管理对于EoE相关并发症的良好结果至关重要.
相关概念视频
Esophageal Perforation-I: Introduction
396
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
396
Esophageal Perforation-II: Clinical Manifestations and Management
467
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
467
Esophageal Strictures-I: Introduction
597
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
597
Barrett Esophagus-II: Clinical Manifestations and Management
743
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
743
Esophageal Strictures-II: Clinical Features and Management
393
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
393
Barrett Esophagus-I: Introduction
572
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
572


