Spontaneous Intramural Perforation of Esophagus with Phlegmonous Esophagitis: A Case Report

自發性食道肌層間破裂：病例報告

許正義(Jane-Yi Hsu) ； 黃克明(Ker-Ming Hung) ； 李世俊(Shih-Chun Lee)

《Journal of Medical Sciences》 18卷2期 (1997/10) Pp. 115-120

摘要

一位六十二歲女性，因胸痛、發燒、吞咽困難而入院。電腦斷層發現食道壁增厚，食道鏡發現食道呈現雙管腔。假管腔為遠端盲端且有膿樣液體存留。經食道攝影檢查，並無發現顯影劑外流。由於病史上無食道外傷或其它食道疾病，故診斷為自發性食道肌層間破裂合併化膿性食道炎。至目前為止英文文獻計載僅有少於六十位案例。此病理機轉目前尚未明瞭，好發於六十多歲 女性，治療上建議禁食保守性療法，經保守性治療後預後良好。若內科治療無效，或食道發展成全層破裂時，即採用外科治療。

關鍵字

食道肌層間破裂 ； 自發性

並列摘要

A 62-year-old female was admitted to our hospital due to dysphagia and fever. The chest CT scan showed thickness of the esophageal wall. The flexible esophagoscopy found a double-barreled esophagus. The blind-end false lumen showed an accumulation of pus-like fluid, but there was no extravasation of contrast medium in the barium esophagography. After admission, the patient was treated conservatively, which included nothing by mouth and supported by parenteral nutrition for three weeks. A repeat flexible esophagoscopy showed the dissected mucosal flap had progressively reattached. On the 36th day after admission, oral fluids intake was well tolerated. She was discharged 2 months after admission in a good healthy status and was swallowing normally with a soft diet. The prognosis for spontaneous intramural perforation of the esophagus is excellent under conservative therapy but close follow-up is necessary.

並列關鍵字

intramural esophageal performation ； spontaneous