Memon Areeka, Dugan Nicholas, Muniraj Thiruvengadam, Hinchcliff Monique E, Masoud Amir
Section of Rheumatology, Allergy, & Immunology, Yale School of Medicine, New Haven, CT.
Department of General Surgery, Hartford Healthcare, Hartford, CT.
ACG Case Rep J. 2025 Apr 5;12(4):e01632. doi: 10.14309/crj.0000000000001632. eCollection 2025 Apr.
We present a case of a 49-year-old woman with diffuse cutaneous systemic sclerosis with refractory gastroesophageal reflux disease and dysphagia for pills and solid foods. Esophagogastroduodenoscopy revealed gastroesophageal intussusception. Despite several interventions including esophageal stent placement, dysphagia persisted. Owing to refractory severe symptoms, the patient underwent a laparoscopic hiatal hernia repair combined with endoscopic transoral incisionless fundoplication. The patient tolerated the intervention well and dysphagia resolved. Although an obscure persistent dysphagia in SSc patients, gastroesophageal intussusception should be considered. This case underscores the need for persistence in the diagnostic evaluation of gastrointestinal symptoms in patients with SSc and highlights the need for a multidisciplinary team care approach.
我们报告一例49岁女性，患有弥漫性皮肤系统性硬化症，伴有难治性胃食管反流病以及吞咽药丸和固体食物困难。食管胃十二指肠镜检查显示胃食管套叠。尽管进行了包括放置食管支架在内的多种干预措施，但吞咽困难仍然存在。由于症状严重且难以治疗，该患者接受了腹腔镜食管裂孔疝修补术联合内镜经口无切口胃底折叠术。患者对该干预耐受良好，吞咽困难得以解决。尽管系统性硬化症患者存在不明原因的持续性吞咽困难，但应考虑胃食管套叠。该病例强调了对系统性硬化症患者胃肠道症状进行持续诊断评估的必要性，并突出了多学科团队护理方法的必要性。
