Kaewdech Apichat, Pattarapuntakul Tanawat, Sripongpun Pimsiri
Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand.
Case Rep Gastroenterol. 2020 Oct 8;14(3):472-476. doi: 10.1159/000509500. eCollection 2020 Sep-Dec.
Pill-induced esophagitis or esophageal ulcers are considered when patients have retrosternal chest pain or odynophagia following the ingestion of suspicious medications. Various drugs have been reported to induce esophageal ulcers. However, amoxycillin-clavulanic acid-induced esophagitis or esophageal ulcer has not been reported in literature. Hence, we report the case of a 30-year-old Thai male who presented with acute, severe odynophagia and retrosternal chest pain. He had a history of taking amoxycillin-clavulanic acid for 12 days. An esophagogastroduodenoscopy was performed and revealed geographic clean-based ulcers, with a kissing-ulcer appearance at the level of the mid-esophagus. A biopsy was taken and revealed inflamed granulation tissue and an ulcer with neither infection nor malignancy. Thus, the diagnosis of an amoxycillin-clavulanic acid-induced esophageal ulcer was made according to the clinicopathologic report.
当患者在摄入可疑药物后出现胸骨后胸痛或吞咽痛时,需考虑药物性食管炎或食管溃疡。据报道,多种药物可诱发食管溃疡。然而,文献中尚未有阿莫西林 - 克拉维酸诱发食管炎或食管溃疡的报道。因此,我们报告一例30岁泰国男性病例,该患者表现为急性、严重的吞咽痛和胸骨后胸痛。他有服用阿莫西林 - 克拉维酸12天的病史。进行了食管胃十二指肠镜检查,发现有地图样、基底干净的溃疡,在食管中段呈对吻溃疡表现。取活检显示为炎性肉芽组织和溃疡,无感染及恶性病变。因此,根据临床病理报告诊断为阿莫西林 - 克拉维酸诱发的食管溃疡。