腐食性食道炎の1例

Corrosive Esophagitis, Report of a Case

要旨　患者は60歳代，男性．レンジクリーナーを誤飲した後より出現した咽頭痛を主訴に来院した．上部消化管内視鏡検査では全食道に多発する白苔付着を伴う縦走性の潰瘍性病変を認めたが，絶食・粘膜保護剤投与など保存的加療で軽快した．

　A sixties man was referred to our hospital with complaints of sorethroat after accidental ingestion of range-cleaner. Endoscopic pictures showed multiple longitudinal ulceration with fur throughout the whole esophagus. These lesions were disappered by conservative care with fast and drug of mucosal protection. Corrosive esophagitis is caused by the ingestion of acids and alkalis. The incidence due to accidental ingestion is high in children, and ingestion in order to commit suicide is the cause in most adult cases. Alkali causes liquiefactive tissue necrosis, and the injury is likely to invade deeply. Because of this the possibility of attention should be paid to esophageal perforation. On endoscopy, lesions are classified into 3 grades : Grade I is characterized by hyperemia, edema, and superficial ulceration of the mucosa. In Grade II, erythema, blister formation, and superficial ulceration accompanied by fibrin exudation occur. Grade III is characterized by epidermal loss, deep ulceration, and the presence of granulation tissue. Black mucosa is a serious finding, for which the possibility of perforation reflecting muscle layer necrosis should be considered.