Lieber Sarah R, Ettenger Norman, Atlas Steven A
Department of Medicine, Division of Gastroenterology and Hepatology, UNC Health Care, Chapel Hill, NC.
Department of Radiology, James J. Peters VA Medical Center, Bronx, NY.
ACG Case Rep J. 2018 Nov 7;5:e77. doi: 10.14309/crj.2018.77. eCollection 2018.
Dysphagia and cough in an older male smoker raise concern for malignancy. However, a history of environmental exposures led to a much more interesting diagnosis in this case of pneumoconiosis due to silicosis. Silicosis is an uncommon pulmonary disease with rare associated gastrointestinal symptoms. We report a bronchoesophageal fistula resulting from silicosis causing dysphagia and cough. This is the first report of using endoscopic stenting to manage an esophageal fistula from silicosis. This case highlights how common symptoms of cough and dysphagia can masquerade as a pulmonary or oropharyngeal problem, when they are actually gastrointestinal manifestations of a rare disease.
一位老年男性吸烟者出现吞咽困难和咳嗽，这引发了对恶性肿瘤的担忧。然而，由于有环境暴露史，在这个因矽肺导致尘肺病的病例中，得出了一个更有趣的诊断结果。矽肺是一种罕见的肺部疾病，很少伴有胃肠道症状。我们报告了一例由矽肺导致的支气管食管瘘，引起吞咽困难和咳嗽。这是首例使用内镜支架治疗矽肺所致食管瘘的报告。该病例凸显出咳嗽和吞咽困难这些常见症状如何在实际上是一种罕见疾病的胃肠道表现时，伪装成肺部或口咽问题。
