Hoxie D A, Dillon M C, Tuckson W B, DeSai R M
Howard University Hospital, Washington, DC, USA.
J Natl Med Assoc. 1995 May;87(5):373-5.
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.
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。
