贲门失弛缓症的延迟诊断和治疗：一例报告。
Delayed diagnosis and treatment of achalasia: a case report.
机构信息
University of Miami Leonard M. Miller School of Medicine, Miami, USA.
出版信息
J Med Case Rep. 2024 Oct 15;18(1):502. doi: 10.1186/s13256-024-04717-7.
BACKGROUND
Achalasia is characterized as an esophageal motility disorder with incomplete relaxation of the lower esophageal sphincter. Achalasia can be associated with abnormal peristalsis and symptoms of dysphagia, acid reflux, and chest pain. The exact pathophysiology of achalasia remains unclear, but it is hypothesized to be due to degeneration of the myenteric plexus.
CASE PRESENTATION
In this case, a 46-year-old Hispanic man presented to the emergency room with a 12-year history of progressive discomfort with swallowing solids and liquids. Due to many years of incomplete follow-up care and lack of understanding of the course of his disease, this patient's symptoms escalated to complete intolerance of oral intake and significant weight loss. He was diagnosed with achalasia during his hospital stay and treated successfully with laparoscopic Heller myotomy.
CONCLUSIONS
This case discussion illustrates the importance of follow-up care and patient education so that diagnosis and treatment of achalasia are not delayed.
背景
贲门失弛缓症的特征是食管动力障碍，表现为下食管括约肌不完全松弛。贲门失弛缓症可伴有异常蠕动，并出现吞咽困难、反酸和胸痛等症状。贲门失弛缓症的确切病理生理学机制尚不清楚，但据推测与肌间神经丛的退行性变有关。
病例介绍
本例为一名 46 岁西班牙裔男性，因进行性吞咽固体和液体困难 12 年，于 12 年前就诊于急诊科。由于多年来未能进行完全随访，且对疾病的病程缺乏了解，该患者的症状逐渐加重，以致完全不能经口摄入食物，并出现明显的体重减轻。该患者在住院期间被诊断为贲门失弛缓症，并成功接受了腹腔镜 Heller 肌切开术治疗。
结论
本病例讨论说明了随访护理和患者教育的重要性，以便及时诊断和治疗贲门失弛缓症，避免延误病情。
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