BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ...BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.展开更多
BACKGROUND Here we report a rare case of submucosal esophageal abscess evolving into intramural submucosal dissection.CASE SUMMARY An 80-year-old woman was admitted to our emergency department with a chief complaint o...BACKGROUND Here we report a rare case of submucosal esophageal abscess evolving into intramural submucosal dissection.CASE SUMMARY An 80-year-old woman was admitted to our emergency department with a chief complaint of dysphagia and fever.Laboratory tests showed mild leukocytosis and elevated C-reactive protein level.Computed tomography showed thickening of the esophageal wall.Upper endoscopy showed a laceration of the esophageal mucosa and a submucosal mass.Spontaneous drainage occurred,and we could see purulent exudate from the crevasse.We closed the laceration with endoscopic clips.The patient did not remember swallowing a foreign body;however,she ate crabs before the symptoms occurred.We prescribed the patient with antibiotic,and the symptoms were gradually relieved.Two months later,upper endoscopy showed that the laceration was healed,and the submucosal abscess disappeared.However,intramural esophageal dissection was formed.We performed endoscopic incision of the septum using dual-knife effectively.CONCLUSION In conclusion,we are the first to report the case of esophageal submucosal abscess evolving into intramural esophageal dissection.The significance of this case lies in clear presentation of the evolution process between two disorders.In addition,we recommend that endoscopic incision be considered as one of the routine therapeutic modalities of intramural esophageal dissection.展开更多
文摘BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.
文摘BACKGROUND Here we report a rare case of submucosal esophageal abscess evolving into intramural submucosal dissection.CASE SUMMARY An 80-year-old woman was admitted to our emergency department with a chief complaint of dysphagia and fever.Laboratory tests showed mild leukocytosis and elevated C-reactive protein level.Computed tomography showed thickening of the esophageal wall.Upper endoscopy showed a laceration of the esophageal mucosa and a submucosal mass.Spontaneous drainage occurred,and we could see purulent exudate from the crevasse.We closed the laceration with endoscopic clips.The patient did not remember swallowing a foreign body;however,she ate crabs before the symptoms occurred.We prescribed the patient with antibiotic,and the symptoms were gradually relieved.Two months later,upper endoscopy showed that the laceration was healed,and the submucosal abscess disappeared.However,intramural esophageal dissection was formed.We performed endoscopic incision of the septum using dual-knife effectively.CONCLUSION In conclusion,we are the first to report the case of esophageal submucosal abscess evolving into intramural esophageal dissection.The significance of this case lies in clear presentation of the evolution process between two disorders.In addition,we recommend that endoscopic incision be considered as one of the routine therapeutic modalities of intramural esophageal dissection.
