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男子进食困难、体重骤降 检查惊见「食道大幅弯曲、塞满食物」

www.livrovencendoanicotina.com2019-07-15
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▲病例食管照片,术前(左)食管酊摄影观察食管S形弯曲和喙型表现,吞咽显影剂停留在食管内;术后(右)开发者可以通过食道进入胃部。 (图片/台北荣提供)

记者洪乔兰/台北报道

67岁的周先生在过去20年中遇到过火灾和胃灼热问题。胃食管反流药物的使用尚未改善。在不久的将来,出现了饮食困难,体重在几个月内迅速下降了10多公斤。台北荣收到此案。通过内窥镜检查,他发现他的食道大大弯曲和扩张。他还充满了未消化的食物。他后来被诊断为罕见的食道延迟。

台北荣基内窥镜诊断治疗中心主任陆俊良表示,新一代高分辨率食管动态检查结果显示食管收缩蠕动减少,加上食管下括约肌压力增大,第一类食管延迟其次是口腔镜下括约肌括约肌切口(POEM),第二天恢复进食并且没有吞咽困难的症状,一个月后体重上升10公斤,成功解决了10多年的问题。

陆俊良指出,食管延迟不能成为食管动力障碍的罕见疾病,其病因不明,可能与病毒感染有关,其发病机制转化为食管肌肉收缩减退和食管下端括约肌松弛功能障碍。

最初的症状是偶尔的反流,在几个月到几年内逐渐发展为吞咽困难和胸痛,严重的情况下,进食后会出现呕吐和体重减轻。由于饮食条件异常,患者的社交活动逐渐减少,严重影响他们的生活质量。

Lu Junliang pointed out that the symptoms of these diseases change slowly and resemble gastroesophageal reflux, which often causes misdiagnosis. Therefore, a series of complete examinations are needed, including upper gastrointestinal endoscopy, excluding structural abnormalities (such as esophageal tumors) and esophagus. Tincture photography and esophageal dynamics examination, etc. in which esophageal dynamics examination is the gold standard for determining diagnosis, the new instrument has a short inspection time and a high success rate, and the diagnosis rate can be doubled.

Treatment of esophageal delay can not be cured, Lu Junliang said that the traditional endoscopic balloon expansion, laparoscopic Heller's esophageal sphincter incision, oral transsphenoidal esophageal sphincter incision is a new development in the past decade Intraocular lens surgery, the therapeutic effect is comparable to or better than traditional treatment. In recent years, the hospital has treated many patients, and the symptoms have alleviated and returned to normal social life.

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