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[食管的碱液腐蚀。长期探条扩张治疗的病程]

[Lye corrosion of the esophagus. Course under long-term bougienage].

作者信息

Adamek H E, Weber J, Benz C, Riemann J F

机构信息

Medizinische Klinik, Klinikum der Stadt Ludwigshafen.

出版信息

Dtsch Med Wochenschr. 1991 Nov 2;116(44):1664-9. doi: 10.1055/s-2008-1063801.

Abstract

In an alcoholic state a 61-year-old woman swallowed by mistake about 125 ml of a lye-containing glass-washing liquid (pH 12). About 30 min later she repeatedly brought up blood-containing vomitus and was admitted to hospital. Extensive corrosive damage in the oesophagus and entire stomach developed within a few days. Two weeks later a circular narrowing of the oesophageal lumen, which could not be passed endoscopically, was seen. Afterwards she repeatedly underwent endoscopic bougie dilatation. At the third dilatation the oesophagus was perforated, mediastinitis occurred but responded without further problems to conservative medical treatment. Two months after the initial injury a Billroth II gastric resection was performed because of complete stenosis of the gastric exit. Bougie dilatation was continued at widening intervals for 18 months after the ingestion. Subsequently the patient has remained without symptoms, although a secondary Barrett oesophagus has developed at the oesophago-gastric junction which, because of the potential danger of malignant degeneration, will require regular follow-up.

摘要

一名61岁女性在醉酒状态下误服了约125毫升含碱液的玻璃清洗液(pH值为12)。约30分钟后,她反复呕出含血呕吐物,并被送往医院。数天内,食管和整个胃部出现广泛的腐蚀性损伤。两周后,可见食管腔出现环形狭窄,内镜无法通过。此后,她反复接受内镜探条扩张术。第三次扩张时食管穿孔,发生纵隔炎,但经保守治疗后未出现进一步问题。初始损伤两个月后,由于胃出口完全狭窄,进行了毕罗Ⅱ式胃切除术。摄入后18个月内,探条扩张术以逐渐延长的间隔持续进行。此后,患者一直无症状,尽管在食管胃交界处出现了继发性巴雷特食管,鉴于其有恶变的潜在风险,需要定期随访。

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