Liu Ying-Ling, Liu Jie, Wang Ye-Tao
Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China.
World J Gastrointest Endosc. 2025 Jan 16;17(1):103404. doi: 10.4253/wjge.v17.i1.103404.
Patients diagnosed with esophageal mucosal bridges often experience symptoms such as chest pain and dysphagia, which pose considerable challenges for endoscopic surgical interventions.
We present a case involving early-stage esophageal cancer discovered in a resting room, notable for the rare manifestation of esophageal mucosal bridging. Following a comprehensive multidisciplinary discussion and the development of a treatment strategy, we proceeded with endoscopic submucosal dissection for the patient. During the procedure, we encountered operational challenges due to the presence of a diverticulum and a partial absence of the muscularis propria. To facilitate the retraction of a portion of the resected specimen, we utilized dental floss. Ultimately, we successfully excised the entire lesion. After a three-day period of fasting with a water-only diet, subsequent iodine water cholangiography did not indicate any perforations, and the patient was advised to transition to a liquid diet. The patient was discharged five days post-operation. A follow-up endoscopy conducted three months later revealed scar-like changes in the mid-esophagus, with the patient reporting no significant discomfort.
In summary, although esophageal mucosal bridges are rarely documented, they should be considered in the differential diagnosis of mechanical dysphagia. Furthermore, endoscopic therapy represents a feasible approach for their management.
被诊断为食管黏膜桥的患者常出现胸痛和吞咽困难等症状,这给内镜手术干预带来了相当大的挑战。
我们报告一例在休息室发现的早期食管癌病例,其显著特点是食管黏膜桥的罕见表现。经过全面的多学科讨论并制定治疗策略后,我们为该患者进行了内镜黏膜下剥离术。手术过程中,由于存在憩室和部分固有肌层缺失,我们遇到了操作挑战。为便于切除标本的一部分回缩,我们使用了牙线。最终,我们成功切除了整个病变。在禁食三天并仅饮水的饮食后,随后的碘水胆管造影未显示任何穿孔,患者被建议过渡到流食。患者术后五天出院。三个月后进行的随访内镜检查显示食管中段有瘢痕样改变,患者报告无明显不适。
总之,尽管食管黏膜桥的记录很少,但在机械性吞咽困难的鉴别诊断中应予以考虑。此外,内镜治疗是其管理的一种可行方法。