Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Aomori, Japan.
Division of Endoscopy, Hirosaki University Hospital, 5-Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Clin J Gastroenterol. 2021 Dec;14(6):1598-1601. doi: 10.1007/s12328-021-01494-4. Epub 2021 Aug 4.
A 76-year-old man was referred to our hospital for examination and treatment of dysphagia. He has been taking enteric-coated aspirin for myocardial infarction. Esophagogastroduodenoscopy (EGD) revealed the presence of esophageal ulcers in the distal esophagus and five to six tablets of enteric-coated aspirin. The esophageal ulcers were believed to have been caused by the retention of aspirin within the esophagus due to achalasia. We substituted enteric-coated aspirin with powdered aspirin. A follow-up EGD performed 1 month later showed improvement of esophageal mucosa. The patient was diagnosed with type I achalasia. Per-oral endoscopic myotomy was performed, and his symptoms improved after the procedure. Although a few studies have investigated the direct effect of aspirin, none of them has reported on the direct effect of aspirin on the esophagus. It might be effective to administer powdered aspirin for patients with achalasia to prevent esophageal ulcers caused by the direct effect of aspirin.
一位 76 岁男性因吞咽困难被转诊至我院检查和治疗。他因心肌梗死一直服用肠溶阿司匹林。食管胃十二指肠镜（EGD）检查发现食管下段存在溃疡，并有五至六片肠溶阿司匹林。考虑到食管动力障碍，阿司匹林在食管内滞留导致了食管溃疡。我们用阿司匹林粉末替代了肠溶阿司匹林。1 个月后进行的 EGD 复查显示食管黏膜有所改善。该患者被诊断为 I 型贲门失弛缓症。行经口内镜肌切开术，术后症状改善。虽然有一些研究调查了阿司匹林的直接作用，但没有一项研究报告阿司匹林对食管的直接作用。对于贲门失弛缓症患者，给予阿司匹林粉末可能有助于预防阿司匹林直接作用引起的食管溃疡。
