Warraich Muhammad Sheharyar, Attar Bashar, Khalid Shazaq, Khaqan Muhammad Ali
Department of Internal Medicine, John H. Stroger Hospital of Cook County, Chicago, Illinois.
Department of Internal Medicine, Punjab Medical College, Faisalabad, Pakistan.
Proc (Bayl Univ Med Cent). 2022 Jun 30;35(6):813-814. doi: 10.1080/08998280.2022.2090813. eCollection 2022.
Acute esophageal necrosis (AEN) is a clinical rarity and its pathogenesis is poorly understood. It usually presents as upper gastrointestinal bleeding and is associated with poor outcomes. We report a case of a 53-year-old man with diabetes and cirrhosis who presented with diabetic ketoacidosis and had an upper gastrointestinal bleed during the hospital stay from AEN associated with esophagitis. In addition to the standard supportive therapy, such patients require antifungal therapy. This case underscores how a rare disease can present like a common disease and prove to be a management challenge if the differential is not kept broad.
急性食管坏死(AEN)临床罕见,其发病机制尚不清楚。它通常表现为上消化道出血,且预后较差。我们报告一例53岁患有糖尿病和肝硬化的男性患者,该患者因糖尿病酮症酸中毒入院,住院期间因与食管炎相关的急性食管坏死出现上消化道出血。除了标准的支持治疗外,此类患者还需要抗真菌治疗。该病例强调了一种罕见疾病如何表现得像常见疾病,如果鉴别诊断不够宽泛,可能会给治疗带来挑战。