Thomas Giovana R, Raynor Tiffany
Department of Otolaryngology-Head and Neck Surgery, University of Miami Hospitals and Clinics, Miami, Fla 33136, USA.
Ear Nose Throat J. 2006 Mar;85(3):187-9.
Complete esophageal stenosis secondary to peptic stricture in the upper esophagus is rare. It is, however a serious medical problem that may require otolaryngologic intervention because of life-threatening dysphagia and weight loss. We report the case of an elderly patient who presented with an upper esophageal stricture, without the typical symptoms of gastroesophageal reflux disease, that progressed to complete esophageal obstruction despite use of proton pump inhibitors and esophageal dilatation. Definitive management of this difficult problem required esophagectomy and gastric pull-up. We discuss the pathophysiology, clinical presentation, differential diagnosis, and multidisciplinary management of peptic esophageal strictures. This case illustrates the difficulty in managing high peptic strictures.
继发于上段食管消化性狭窄的完全性食管狭窄较为罕见。然而,这是一个严重的医学问题,由于危及生命的吞咽困难和体重减轻,可能需要耳鼻喉科进行干预。我们报告一例老年患者,其表现为上段食管狭窄,无胃食管反流病的典型症状,尽管使用了质子泵抑制剂和食管扩张术,但仍进展为完全性食管梗阻。对这一难题的确定性治疗需要进行食管切除术和胃上提术。我们讨论了消化性食管狭窄的病理生理学、临床表现、鉴别诊断和多学科管理。该病例说明了处理高位消化性狭窄的困难。