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近期新冠病毒感染后急性起病的贲门失弛缓症:一例报告

Acute-Onset Achalasia Following a Recent COVID-19 Infection: A Case Report.

作者信息

Wasim Asad Ullah, Khan Muhammad Wasim, Khan Osama A, Almatraf Kholoud Soliman

机构信息

Internal Medicine, Air University - Fazaia Medical College, Islamabad, PAK.

Division of Clinical and Translational Research, Larkin Community Hospital, Miami, USA.

出版信息

Cureus. 2023 May 9;15(5):e38803. doi: 10.7759/cureus.38803. eCollection 2023 May.

Abstract

Achalasia is a rare esophageal motility disorder that leads to dysphagia, regurgitation, and several other symptoms. While the etiology of achalasia is not completely understood, studies have suggested an immune reaction to viral infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as a potential cause. Here, we present a case report of a previously healthy 38-year-old male who presented to the emergency room with severe shortness of breath, recurrent vomiting, and dry cough, that had progressively worsened over five days. The patient was diagnosed with coronavirus disease 2019 (COVID-19), and a chest CT also revealed prominent features of achalasia with a markedly dilated esophagus and areas of narrowing at the distal esophagus. The initial management of the patient included IV fluids, antibiotics, anticholinergics, and corticosteroid inhalers which improved his symptoms. This case report highlights the importance of considering the acute-onset of achalasia in COVID-19 patients and the need for further research on the potential association between SARS-CoV-2 and achalasia.

摘要

贲门失弛缓症是一种罕见的食管动力障碍性疾病,可导致吞咽困难、反流及其他多种症状。虽然贲门失弛缓症的病因尚未完全明确,但研究表明,对包括严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在内的病毒感染产生的免疫反应可能是其病因。在此,我们报告一例病例,一名38岁既往健康男性因严重气短、反复呕吐和干咳就诊于急诊室,这些症状在五天内逐渐加重。该患者被诊断为2019冠状病毒病(COVID-19),胸部CT还显示出贲门失弛缓症的显著特征,食管明显扩张,食管远端有狭窄区域。患者的初始治疗包括静脉输液、抗生素、抗胆碱能药物和皮质类固醇吸入器,这些措施改善了他的症状。本病例报告强调了在COVID-19患者中考虑贲门失弛缓症急性发作的重要性,以及对SARS-CoV-2与贲门失弛缓症之间潜在关联进行进一步研究的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e40c/10250781/e1ba79ed5bcb/cureus-0015-00000038803-i01.jpg

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