临床误诊误治2017，Vol.30Issue(7)：51-53,3.DOI:10.3969/j.issn.1002-3429.2017.07.017
容易与胃食管反流病混淆的食管下段憩室(附2例误诊报告)
Easily Be Confused Epiphrenic Esophageal Diverticulum with Gastroesophageal Reflux Disease: a Report for 2 Misdiagnosed Cases
摘要
Abstract
Objective To investigate clinical characteristics, diagnosis and treatment methods of lower esophageal esophageal diverticulum in order to avoid misdiagnosis.Methods clinical data of 2 patients with epiphrenic diverticulum, who were misdiagnosed as having gastroesophageal reflux disease (GERD), was retrospectively analyzed.Results The 2 female patients with epiphrenic esophageal diverticulum complained sour regurgitation, heartburn, repeated precordium (subdural-chest) pain, bucking or chronic irritable cough and choking in pars laryngea pharyngis, and the patients were misdiagnosed as having GERD in other hospital and were transferred to our hospital for undergoing surgery.DeMeester score was not more than 14.72 points 24 h after admission by esophageal pH monitoring, and fiber gastroscope and upper gastrointestinal angiography showed mucosal inflammation and congestion in the lower esophageal with a visible diverticulum at 38-40 cm position from the incisors.The diverticulum had short segment pedicle which connected with the lower esophagus, and then lower esophageal esophageal diverticulum was confirmed.Surgical and drug treatments were given, and symptoms were partially or completely relieved.Conclusion Lower esophageal esophageal diverticulum is easily confused as GERD.Endoscopy, 24 h esophageal pH monitoring and high-resolution pressure esophageal pressure test are needed for differential diagnosis.Antireflux surgery combined with diverticulectomy may be an effective method in intervention of lower esophageal esophageal diverticulum.关键词
憩室,食管/误诊/胃食管反流/外科手术Key words
Diverticulum/esophageal/Misdiagnosis/Gastroesophageal reflux/Surgical procedures/operative分类
医药卫生引用本文复制引用
张超,李非,刘殿刚,吴继敏,高翔,胡志伟,杜兴,王峰,汪忠镐..容易与胃食管反流病混淆的食管下段憩室(附2例误诊报告)[J].临床误诊误治,2017,30(7):51-53,3.基金项目
首都医科大学宣武医院院级课题(2016-04) （2016-04）
北京市215高层次卫生技术人才学术骨干项目(0080088) （0080088）
