Kang Taekyung, Kang Mi-Jin
Department of Emergency Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
Department of Radiology, Inje University Sanggye Paik Hospital, Seoul, Korea.
Mediastinum. 2024 Jul 15;8:53. doi: 10.21037/med-24-16. eCollection 2024.
Emphysematous esophagitis is a very rare disease and there are only a few previous reports in the literature. Previously reported cases have resulted in emphysematous esophagitis following anterior cervical procedures or ingestion of hydrogen peroxide (HP). In this report, we describe a case in which a patient with emphysematous esophagitis accompanied by gastritis without the above predisposing factors was treated with conservative treatment.
A 65-year-old woman was admitted to Inje University Sanggye Paik Hospital with general weakness, abdominal discomfort, nausea and chest discomfort. On chest and abdominal radiographs, there were abnormal air density in upper mediastinum and abdomen. Chest and abdomen computed tomography (CT) revealed mural air at entire esophagus and stomach. The patient managed with proton pump inhibitor (PPI), broad spectrum antibiotic therapy, and total parenteral nutrition (TPN).
Emphysematous gastritis occurs mainly along with emphysematous gastritis, with a mortality rate of up to 62%. It is mainly known to be caused by infection of the esophageal wall by gas forming bacteria, but there are also cases where there is no ingestion or exact cause. There is still controversy about treatment methods due to the high death rate, but if detected early like the reported patient, a good outcome can be expected with conservative treatment alone.
气肿性食管炎是一种非常罕见的疾病，文献中仅有少数先前报道。先前报道的病例是在前路颈椎手术后或摄入过氧化氢（HP）后发生气肿性食管炎。在本报告中，我们描述了一例无上述诱发因素的气肿性食管炎伴胃炎患者接受保守治疗的病例。
一名65岁女性因全身乏力、腹部不适、恶心和胸部不适入住仁济大学圣心医院。胸部和腹部X线片显示上纵隔和腹部有异常气体密度。胸部和腹部计算机断层扫描（CT）显示整个食管和胃壁有气体。该患者接受质子泵抑制剂（PPI）、广谱抗生素治疗和全胃肠外营养（TPN）。
气肿性胃炎主要与气肿性食管炎同时发生，死亡率高达62%。主要已知是由产气细菌感染食管壁引起，但也有未摄入或确切病因不明的病例。由于死亡率高，治疗方法仍存在争议，但如果像报告的患者那样早期发现，仅采用保守治疗即可预期良好的结果。
