Yamamoto Naoto, Nakamura Masaki, Tachibana Shougo, Konno Hiroyuki, Nakamura Satoshi, Nishino Nobuhiko
Department of Surgery, Morimachi Public Hospital, Shizuoka, Japan.
Surg Today. 2002;32(6):519-22. doi: 10.1007/s005950200089.
A 62-year-old man with a chief complaint of coughing up blood was revealed to have Mallory-Weiss syndrome with arterial bleeding by gastrointestinal endoscopy at the esophagogastric junction, and two teardrop-shaped fissures were found longitudinally extending into the muscle layer. Endoscopic treatment with ethanol injection and the administration of a thrombin solution spray failed to control the arterial bleeding. Hemostasis was finally archived by suturing the fissures under an open laparotomy. A postoperative barium esophagogram showed multiple flask-shaped outpouchings in the thoracic esophagus, and a diagnosis of esophageal intramural pseudodiverticulosis (EIPD) was thus made. EIPD is usually accompained with esophageal strictures but esophageal bleeding is rare.
一名62岁男性,以咯血为主诉,经胃肠内镜检查发现食管胃交界处有马洛里-魏斯综合征伴动脉出血,发现两条纵向延伸至肌层的泪滴状裂缝。内镜下注射乙醇及喷洒凝血酶溶液治疗未能控制动脉出血。最终通过开腹手术缝合裂缝实现止血。术后食管钡餐造影显示胸段食管有多个烧瓶状憩室,因此诊断为食管壁内假性憩室病(EIPD)。EIPD通常伴有食管狭窄,但食管出血罕见。