Acute necrotizing esophagitis: role of nonsteroidal anti-inflammatory drugs
Acute necrotizing esophagitis: role of nonsteroidal anti-inflammatory drugs
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DOI：
10.1007/s00535-005-1741-6
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发表时间：
2006-03-01
影响因子：
6.3
通讯作者：
Yoshiba, M
中科院分区：
文献类型：
--
作者：
Yasuda, H;Yamada, M;Yoshiba, M
背景急性坏死性食管炎（ANE）是一种少见的上消化道出血性疾病，本文分析了ANE在上消化道出血患者中的发病率、临床特点、合并症及用药史。方法.回顾性分析了16例ANE患者的临床和内窥镜检查结果以及3年内的临床病程。结果我们观察了16例（6%）ANE患者在239例上消化道出血在3年期间。患者的平均年龄为62.5岁。病变主要累及食管的下三分之一，食管裂孔疝是最常见的（63%）并存内镜检查结果。所有患者均有并存疾病。50%的ANE患者（8例）服用了非甾体抗炎药（NSAID）。4例糖尿病酮症酸中毒患者也发生ANE。支持治疗，包括肠外营养和质子泵抑制剂的管理，是有效的。结论. ANE比以前报道的更常见，它应该被纳入UGI出血的鉴别诊断。ANE可被描述为“急性食管粘膜病变”，特别是在患有食管裂孔疝的老年患者和服用NSAID的患者中。
Background. Acute necrotizing esophagitis (ANE) is a rarely described entity that is thought to be a Cause of upper gastrointestinal (UGI) bleeding, The present study examined the incidence of ANE among patients with UGI bleeding, as well as the clinical features of ANE, and the coexisting illnesses and medication histories of ANE patients. Methods. A retrospective analysis of clinical and endoscopic findings and the clinical course in 16 patients with ANE was carried Out over a 3-year period. Results. We observed 16 patients (6%) of ANE in 239 patients with UGI bleeding during the 3-year period. The average age of the patients was 62.5 years. The lesions predominantly affected the lower third of the esophagus, and hiatal hernia was the most common (63%) coexisting endoscopic finding. All patients had coexisting disease. Fifty percent of patients with ANE (eight patients) had taken nonsteroidal anti-inflammatory drugs (NSAIDs). ANE also occurred in four patients with diabetic ketoacidosis. Supportive therapy, including parenteral nutrition and administration of a proton pump inhibitor, was effective. Conclusions. ANE is more common than has been previously reported, and it should be included in the differential diagnosis of UGI bleeding. ANE Could be characterized as an "acute esophageal mucosal lesion," particularly in aged patients with hiatal hernia and among those who consume NSAIDs.