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NEJM:贲门失弛缓症患者的螺旋状食管-病例报道

2020-04-30 MedSci原创 MedSci原创

高分辨率食管测压发现食管下括约肌的综合舒张压升高,不蠕动,与III型(痉挛性) 贲门失弛缓症相一致的痉挛性收缩。

患者为一名83岁的妇女,因进餐时出现的吞咽困难和反流,并伴有餐后胸痛,而到消化内科就诊。

几年来,她一直难以吞咽固体和液体食物,而且这种症状在就诊前的一年中已经恶化。她还报告说,去年体重减轻了9公斤。

钡盐食管图呈螺旋状(如图A所示)。上消化道内镜检查发现非蠕动性痉挛性收缩(如图B所示)和胃食管连接紧密。高分辨率食管测压发现食管下括约肌的综合舒张压升高,不蠕动,与III型(痉挛性) 贲门失弛缓症相一致的痉挛性收缩。

该患者拒绝内镜下肌切开术,并选择内镜下注射肉毒杆菌毒素进行治疗。治疗后5个月的随访中,她仅有间歇性吞咽困难,没有反流。

原始出处:

Samuel Han,et al.Corkscrew Esophagus in Achalasia.N Engl J Med 2020;https://www.nejm.org/doi/full/10.1056/NEJMicm1911516

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    2020-11-11 青忧禾支

    学习了

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    2020-05-01 zhouqu_8
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    2020-04-30 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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