D'Alteroche L, Bourlier P, Picon L, Viguier J, Metman E H, Machet M C, de Calan L
Service d'Hépato-Gastroentérologie, Centre Hospitalier Regional et Universitaire, Tours.
Gastroenterol Clin Biol. 1998 May;22(5):541-5.
We report the case of a 61-year-old-man with an eosinophilic esophagitis with esophageal motor disorder associated with toxocariasis. He complained of non cardiac chest pain and had eosinophilia leading to the detection of Toxocara canis infection. Pain persisted despite treatment of toxocariasis. Basal manometry was normal but ambulatory 24-hour manometry-pHmetry showed diffuse esophageal spasm. Ultrasonography showed a thickening of the esophageal musculature in the two inferior thirds of the esophagus. After failure of treatment with sodium cromoglycate steroids and esophageal dilatation, calcium antagonists were partially effective. A long esophageal myotomy was performed permiting the disappearance of symptoms. The histological examination of a side myotomy biopsy showed an eosinophilic infiltration of the esophageal muscle layer. This observation leads to discuss the possible relation between toxocariasis, the esophageal motor disorder and the eosinophilic infiltration of the esophageal muscle layer.
我们报告了一例61岁男性患者，患有嗜酸性食管炎并伴有与弓蛔虫病相关的食管运动障碍。他主诉非心源性胸痛，且存在嗜酸性粒细胞增多症，进而检测出犬弓蛔虫感染。尽管对弓蛔虫病进行了治疗，但疼痛仍持续存在。基础测压正常，但动态24小时测压-食管pH值监测显示弥漫性食管痉挛。超声检查显示食管下三分之二的食管肌肉组织增厚。在色甘酸钠、类固醇治疗及食管扩张治疗失败后，钙拮抗剂有部分疗效。进行了长段食管肌切开术，症状得以消失。肌切开术侧活检的组织学检查显示食管肌层有嗜酸性粒细胞浸润。该观察结果引发了对弓蛔虫病、食管运动障碍及食管肌层嗜酸性粒细胞浸润之间可能关系的讨论。
