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一名青少年男性反复吞咽困难和胸痛的罕见病因

An Uncommon Cause of Recurrent Dysphagia and Chest Pain in an Adolescent Boy.

作者信息

Craveiro Costa Ricardo, Patena Forte Joana, Correia Marta, Borges Cristina, Faria Hugo

机构信息

Pediatrics, Pediatric Hospital, Local Health Unit of Coimbra, Coimbra, PRT.

Pediatrics, Child and Adolescent Center, CUF Descobertas Hospital, Lisbon, PRT.

出版信息

Cureus. 2024 Jul 16;16(7):e64648. doi: 10.7759/cureus.64648. eCollection 2024 Jul.

Abstract

An 11-year-old boy was brought to the emergency department with a week-long history of widespread pain in his upper abdomen that worsened with deep breathing and eating, sialorrhea, food impaction sensation, and a recent fever. Ten months prior, he had similar symptoms and was diagnosed with a pharyngeal phlegmon. He was treated with antibiotics and dexamethasone. In the current episode, he presented with mild elevation of inflammatory markers, a slight deviation of the trachea on chest X-ray, and a tubular esophageal duplication was identified on a thoracic CT, with its opening observed during the endoscopic study. The patient was admitted for further treatment with fluids, analgesia, and antibiotics, and showed improvement over the next seven days with no significant incidents. Esophageal duplications are a rare congenital anomaly and their exact cause is unknown. Typically found in the posterior mediastinum and lower esophagus, they can cause symptoms such as pain, dysphagia, regurgitation, and malnutrition. Surgical or endoscopic resection can be a treatment option for these malformations.

摘要

一名11岁男孩因上腹部广泛疼痛一周被送往急诊科,疼痛在深呼吸和进食时加重,伴有流涎、食物嵌塞感及近期发热。10个月前,他曾有类似症状,被诊断为咽脓肿。当时接受了抗生素和地塞米松治疗。在此次发作中,他炎症指标轻度升高,胸部X线显示气管轻度偏移,胸部CT发现一个管状食管重复畸形,在内镜检查时观察到其开口。患者入院接受补液、镇痛及抗生素治疗,在接下来的7天里病情好转,未出现重大事件。食管重复畸形是一种罕见的先天性异常,其确切病因尚不清楚。通常位于后纵隔和食管下段,可引起疼痛、吞咽困难、反流和营养不良等症状。手术或内镜切除可作为这些畸形的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f80e/11328823/a77f5bd27296/cureus-0016-00000064648-i01.jpg

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