Miida Suguru, Arao Yoshihisa, Takeda Nobutaka, Goto Shu, Kojima Yuichi, Kimura Naruhiro, Hayashi Kazunao, Tsuchiya Atsunori, Terai Shuji
Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences, Niigata University Niigata Japan.
Department of Gastroenterology and Hepatology Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital Niigata Japan.
DEN Open. 2023 Jul 3;4(1):e260. doi: 10.1002/deo2.260. eCollection 2024 Apr.
Several cases of esophageal stenosis caused by cervical vertebral osteophytes have been reported; however, few reports of esophageal stenosis caused by thoracic osteophytes are available. We describe the case of an 86-year-old man with esophageal stenosis caused by a thoracic osteophyte near the tracheal bifurcation. An endoscopic ultrasonography examination was scheduled to determine the cause of acute pancreatitis; however, lacerations observed at the bifurcation following endoscope removal during prior esophagogastroduodenoscopy led us to cancel the ultrasonography to avoid potential esophageal perforation. A review of the present case and six similar previous cases of thoracic osteophyte-associated esophageal stenosis (identified via a systematic search of the PubMed database) demonstrated the clinical importance of a thoracic osteophyte near physiological esophageal stenosis. Esophagogastroduodenoscopy and computed tomography should be performed to screen for vertebral osteophytes before endoscopic ultrasonography, endoscopic retrograde cholangiopancreatography, and transesophageal echocardiography to avoid iatrogenic accidents.
已有数例颈椎骨赘导致食管狭窄的病例报道；然而，关于胸椎骨赘导致食管狭窄的报道却很少。我们描述了一名86岁男性因气管分叉处附近的胸椎骨赘导致食管狭窄的病例。原计划进行内镜超声检查以确定急性胰腺炎的病因；然而，在先前的食管胃十二指肠镜检查过程中，内镜取出后在分叉处观察到撕裂伤，这使我们取消了超声检查，以避免潜在的食管穿孔。对本病例及之前6例类似的胸椎骨赘相关性食管狭窄病例（通过对PubMed数据库进行系统检索确定）的回顾表明，生理食管狭窄附近的胸椎骨赘具有临床重要性。在内镜超声检查、内镜逆行胰胆管造影和经食管超声心动图检查之前，应进行食管胃十二指肠镜检查和计算机断层扫描以筛查椎体骨赘，以避免医源性事故。
