Penagini R, Ranzi T, Velio P, Zannini P, Negri G, Pezzuoli G, Bianchi P A
Istituto di Scienze Mediche, University of Milan, Italy.
Gut. 1989 Nov;30(11):1624-9. doi: 10.1136/gut.30.11.1624.
A 40 year old man with dysphagia and a giant fibrovascular polyp of the oesophagus is reported. The patient was followed for two years before removal of the polyp. During this period the tumour markedly increased in size and the oesophagus reached a maximum diameter of 5.9 cm. In presence of the polyp the body of the oesophagus had no pressure activity after swallows and a 22 hour intraoesophageal pH record showed pH greater than 7 for 31.4% of the time and never pH less than 4. After excision of the tumour the oesophagus regained normal size and peristalsis. Intraoesophageal pH greater than 7 and less than 4 were recorded for 1.6% and 16.1% of the time respectively. Dysmotility was probably a contributing factor to the genesis of dysphagia induced by the giant fibrovascular polyp. Prolonged alkalinisation of intraoesophageal pH conceivably reflected altered oesophageal clearing of alkaline salivary and/or oesophageal secretions.
报告了一名40岁患有吞咽困难和巨大食管纤维血管息肉的男性患者。在切除息肉前对该患者进行了两年的随访。在此期间，肿瘤大小显著增加，食管最大直径达到5.9厘米。存在息肉时，食管体部在吞咽后无压力活动，22小时食管内pH记录显示pH大于7的时间占31.4%，且从未低于4。切除肿瘤后，食管恢复正常大小和蠕动。食管内pH大于7和小于4的记录时间分别为1.6%和16.1%。动力障碍可能是巨大纤维血管息肉引起吞咽困难的一个促成因素。食管内pH的长期碱化可能反映了食管对碱性唾液和/或食管分泌物清除的改变。
