Thaker Sarang, Pajot Gregory, Mikolajczyk Adam E, Lipowska Anna M
Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, Chicago, USA.
Cureus. 2021 Aug 14;13(8):e17172. doi: 10.7759/cureus.17172. eCollection 2021 Aug.
Esophagitis causing upper gastrointestinal bleeding (UGIB) is associated with significant morbidity. We present a case report of two patients with hemorrhagic shock secondary to esophagitis. Both patients underwent esophagogastroduodenoscopy demonstrating severe bleeding pan-esophagitis complicated by hemodynamic instability. Balloon tamponade for hemostasis was performed with resultant hemodynamic improvement. Severe UGIB secondary to esophagitis is difficult to control, with a high risk of complications and limited available endoscopic therapies in extensive mucosal injury. Treatments such as angiography are ineffective due to collateralization and surgery carries high morbidity and mortality. Balloon tamponade provides a rescue option for severe, refractory UGIB secondary to esophagitis.
导致上消化道出血(UGIB)的食管炎与显著的发病率相关。我们报告两例因食管炎继发失血性休克的病例。两名患者均接受了食管胃十二指肠镜检查,显示严重的全食管炎伴出血,并伴有血流动力学不稳定。进行了气囊压迫止血,血流动力学得到改善。食管炎继发的严重UGIB难以控制,并发症风险高,且在广泛黏膜损伤时可用的内镜治疗有限。由于侧支循环,血管造影等治疗无效,手术的发病率和死亡率很高。气囊压迫为食管炎继发的严重难治性UGIB提供了一种挽救选择。