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膈上憩室大量出血:一项不寻常的发现。

Profuse bleeding in epiphrenic diverticula: an unusual finding.

作者信息

Hoxie D A, Dillon M C, Tuckson W B, DeSai R M

机构信息

Howard University Hospital, Washington, DC, USA.

出版信息

J Natl Med Assoc. 1995 May;87(5):373-5.

Abstract

Profuse bleeding is an unusual and previously unreported finding in epiphrenic diverticula. The present case describes a man with a history of significant alcohol and tobacco abuse who presented to an emergency room expectorating blood and was then admitted. Further evaluation revealed a large bleeding ulcer crater in the distal esophagus. Findings consistent with candida esophagitis were noted on biopsy. Radiographic examination revealed two large, wide-mouthed diverticula. While hypertensive lower esophageal pressure was noted on manometric evaluation, surgery was not performed on the patient, and he subsequently curtailed his alcohol and tobacco intake. A follow-up examination at 90 days' postdischarge revealed no further bleeding episodes with continued decreased alcohol and tobacco intake.

摘要

大量出血是膈上憩室中一种不常见且此前未被报道过的表现。本病例描述了一名有大量酗酒和吸烟史的男性,他到急诊室时咳出鲜血,随后入院。进一步检查发现食管远端有一个大出血性溃疡灶。活检发现符合念珠菌食管炎的表现。影像学检查显示有两个大的、宽口憩室。虽然测压评估发现食管下段压力升高,但未对该患者进行手术,他随后减少了酒精和烟草摄入量。出院后90天的随访检查显示,随着酒精和烟草摄入量持续减少,未再出现出血情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44a9/2607792/6303169f4d6a/jnma00394-0062-a.jpg

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