Liguori Gennaro, Cortale Maurizio, Cimino Fabrizio, Sozzi Michele
Department of General and Thoracic Surgery, Cattinara Hospital, Strada di Fiume 447, Trieste 34149, Italy.
World J Gastroenterol. 2008 Feb 7;14(5):803-4. doi: 10.3748/wjg.14.803.
A young man with a previous history of episodes of mild solid food dysphagia was admitted with a total dysphagia. The esophagogastroduodenoscopy (EGDS) showed an extensive disruption of mucosal layer with a cul-de-sac in the lower part of the esophagus. Soon after the procedure, the patient suffered from an acute chest pain and subsequent CT scan demonstrated an intramural circumferential dissection of thoracic esophagus, and a mediastinal emphysema. An emergency right thoracotomy was performed, followed by a total esophagectomy with esophagogastroplasty and jejunostomy. The histopathology confirmed that mucosal and submucosal layers were circumferentially detached from muscular wall and showed an eosinophilic infiltration of the whole organ with necrosis and erosions of mucosal, submucosal and muscular layers. The diagnosis was esophageal perforation in eosinophilic esophagitis.
一名有轻度固体食物吞咽困难发作史的年轻男子因完全性吞咽困难入院。食管胃十二指肠镜检查（EGDS）显示黏膜层广泛破坏，食管下段有盲端。检查后不久，患者出现急性胸痛，随后的CT扫描显示胸段食管壁内环形剥离，并伴有纵隔气肿。进行了急诊右胸切开术，随后进行了全食管切除术、食管胃成形术和空肠造口术。组织病理学证实黏膜层和黏膜下层与肌壁周向分离，整个器官显示嗜酸性粒细胞浸润，伴有黏膜层、黏膜下层和肌层的坏死和糜烂。诊断为嗜酸性食管炎并发食管穿孔。
