ダビガトラン起因性食道潰瘍

Dabigatran-induced Esophageal Ulcer

要旨●ダビガトラン起因性食道潰瘍で特徴的な画像・経過を呈した2症例について報告する．［症例1］は78歳，男性で，上部消化管内視鏡検査（EGD）にて中部食道に円形の打ち抜き様潰瘍の集簇がみられた．［症例2］は80歳，男性で，EGDにて中部から下部食道に全周性に白色の膜様物がみられ，下部には浅い潰瘍がみられた．膜様物は過去の報告でも記載されており，ダビガトランによる食道潰瘍に特徴的な所見と考えられた．膜様物を採取して検討したところ，ダビガトランカプセルであることが疑われ，ダビガトラン起因性食道潰瘍はカプセルが食道に付着しやすいことにより発生していることが示唆された．

We report two cases of esophageal ulcers induced by dabigatran, which showed characteristic findings and course of progression. The first case was that of a 78-year-old man with an EGD showing multiple, round, punched-out ulcers in the middle esophagus. The second case was that of an 80-year-old man with EGD, showing a white membranous substance that adhered to the middle-lower esophagus, and shallow ulcers in the lower esophagus. The substance has also been described in earlier reports and is considered to be a characteristic finding of dabigatran-induced esophageal ulcer. We isolated and examined the white membranous substance, which we suspect to be dabigatran capsules. Based on these findings, dabigatran-induced esophageal ulcer may have been caused by the adherence of dabigatran capsules to the esophageal lining.