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贲门失弛缓症合并食管壁内血肿:病例报告及文献复习。

Achalasia combined with esophageal intramural hematoma: case report and literature review.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Taipei 111, Taiwan, China.

出版信息

World J Gastroenterol. 2010 Nov 14;16(42):5391-4. doi: 10.3748/wjg.v16.i42.5391.

Abstract

A 62-year-old male patient was admitted to our hospital due to severe chest pain, odynophagia, and hematemesis. Chest computed tomography showed an esophageal submucosal tumor. Esophagogastroduodenoscopy (EGD) revealed a longitudinal purplish bulging tumor of the esophagus. Endoscopic ultrasound (EUS) showed a mixed echoic tumor with partial liquefaction from the submucosal layer. The patient was diagnosed with esophageal intramural hematoma as well as achalasia by upper gastrointestinal endoscopy, esophagography and esophageal manometry. The patient was managed conservatively with intravenous nutrition, and oral feeding was discontinued. Follow-up EGD and EUS showed complete recovery of the esophageal wall, and finally, the patient underwent endoscopic dilatation for achalasia. The patient was symptom free at the time when we wrote this manuscript.

摘要

一位 62 岁男性患者因剧烈胸痛、吞咽困难和呕血被收入我院。胸部计算机断层扫描显示食管黏膜下肿瘤。食管胃十二指肠镜检查(EGD)显示食管纵向紫蓝色隆起性肿瘤。内镜超声(EUS)显示源于黏膜下层的混合回声肿瘤,部分液化。上消化道内镜、食管造影和食管测压诊断为食管壁内血肿和贲门失弛缓症。患者采用静脉营养支持治疗,停止口服喂养。随访 EGD 和 EUS 显示食管壁完全恢复,最终患者因贲门失弛缓症而行内镜扩张治疗。患者在撰写本文时无症状。

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本文引用的文献

3
Dissecting intramural haematoma of the oesophagus.
QJM. 1998 Oct;91(10):701-5. doi: 10.1093/qjmed/91.10.701.
4
Intramural hematoma of the esophagus: appearance on magnetic resonance imaging.
Magn Reson Imaging. 1995;13(7):1037-42. doi: 10.1016/0730-725x(95)00047-k.
7
Intramural rupture of the oesophagus.食管壁内破裂
Br Med J. 1968 Aug 31;3(5617):536-7. doi: 10.1136/bmj.3.5617.536.
9
Spontaneous intramural oesophageal haematoma.自发性食管壁内血肿
Clin Radiol. 1988 Nov;39(6):628-34. doi: 10.1016/s0009-9260(88)80076-x.
10
Oesophageal haematoma: report of three cases.食管血肿:三例报告。
Clin Radiol. 1988 Jul;39(4):462-3. doi: 10.1016/s0009-9260(88)80314-3.

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