Kono S, Kaida K, Kawai M
First Department of Internal Medicine, Hamamatsu University School of Medicine.
Rinsho Shinkeigaku. 1998 Mar;38(3):238-41.
We reported a 63-year-old woman with myotonic dystrophy (MD), who had frequent swallowing disturbances and died from suffocation asphyxia. Her esophagus on CT image 30 minutes after taking semi-solid meal showed dietary remnants in the middle portion of esophagus with entire esophageal dilatation. At autopsy, there was marked atrophy in the striated muscles in the upper part and smooth muscles in the lower part of the esophagus. The site of dietary stagnation on CT image was identical to the atrophic smooth muscle layer seen at autopsy. We speculate that one of the causes of esophageal motor dysfunctions is smooth muscle atrophy. The dietary stagnation in the esophagus may increase a risk of the asphyxia. Therefore we need to keep patients at the straight position during and after dietary ingestion to prevent respiratory problems.
我们报告了一名63岁患有强直性肌营养不良（MD）的女性，她频繁出现吞咽障碍并死于窒息。在摄入半固体食物30分钟后的CT图像上，她的食管显示食管中部有食物残渣且食管全程扩张。尸检时，食管上部的横纹肌和下部的平滑肌有明显萎缩。CT图像上食物停滞的部位与尸检时所见的萎缩平滑肌层一致。我们推测食管运动功能障碍的原因之一是平滑肌萎缩。食管内的食物停滞可能会增加窒息风险。因此，我们需要在患者进食期间及进食后让其保持直立位，以预防呼吸问题。
