Möschler O, Müller M K
Klinik für Allgemeine Innere Medizin, Marienhospital Osnabrück, Germany.
Dtsch Med Wochenschr. 2002 Oct 4;127(40):2063-6. doi: 10.1055/s-2002-34514.
A 56-year-old man presented himself at our polyclinic with the symptoms of dyspnoea at rest and exhaustion. The case history revealed an alcoholic liver cirrhosis (Child B) and recurrent heart burn as a sign of a gastro-esophageal reflux disease. The examination showed jaundice and enlargement of the liver as pathological features.
At gastroscopy multiple openings of pseudodiverticula and a high-grade inflammatory reaction of the esophageal mucosa was found, indicating pseudodiverticulosis of the esophagus. After staining with lugol-solution and directed biopsy of unstained areas there was no sign of malignancy in the histopathological report.
The candida esophagitis and gastroesophageal reflux disease were treated with antimycotic and proton-pump-inhibiting drugs after which the patient had no more complains. Regular gastroscopic controls are planned.
Pseudodiverticulosis of the esophagus is a very rare disease which arises from ductal dilatation of the mucosal glands during chronic inflammation of the esophagus. In most cases the pseudodiverticulosis is an accidental finding without symptoms. Risks can arise from the most frequent complications like development of inflammatory strictures, motility disorders and transformation to malignancy. Therefore it is necessary to perform regular inspection of the esophagus by endoscopy.
一名56岁男性因静息时呼吸困难和乏力前来我院门诊就诊。病史显示有酒精性肝硬化(Child B级)以及作为胃食管反流病体征的反复烧心症状。检查发现黄疸和肝脏肿大为病理特征。
胃镜检查发现多个假性憩室开口以及食管黏膜的重度炎症反应,提示食管假性憩室病。经卢戈氏溶液染色并对未染色区域进行定向活检后,组织病理学报告未发现恶性迹象。
念珠菌性食管炎和胃食管反流病采用抗真菌和质子泵抑制药物治疗,之后患者不再有不适主诉。计划定期进行胃镜检查。
食管假性憩室病是一种非常罕见的疾病,由食管慢性炎症期间黏膜腺管扩张引起。在大多数情况下,食管假性憩室病是偶然发现且无症状。最常见的并发症如炎症性狭窄、动力障碍以及恶变可能带来风险。因此,有必要定期通过内镜检查食管。