腐蝕性食道炎と二次性食道狭窄

A CASE REPORT OF CORROSIVE ESOPHAGITIS

　Ⅰ．緒言

　本邦では，稀な疾患に属するものの一つとして，食道狭窄（腐蝕性食道炎，アルカリまたは酸の誤嚥による食道炎，二次的食道狭窄）がある。

　これに関しては，Weakら^9）による，洗剤を用いた動物実験，経日的な粘膜変化の観察以外に，食道の粘膜の変化をより詳細に，また，より頻回に観察報告したものはない。一方，Cardona ＆ Daly^11）は，239例の臨床症例をまとめ，くわしく，その病理所見と治療法について報告している。おおよそ，その耳鼻科的治療方針は確立されてきており，外科的処置のみにたよる従来の治療方針が修正されつつある。

　筆者らは，成人に発生した。食道炎一食道狭窄の1例を経験し，ステロイドホルモン療法と，頻回に実施した食道鏡による経過観察と，食道拡張術（マーキュリーブジーによる）で，高度の狭窄を予防することができたので内視鏡所見とともに報告する。

　An 18-year-old male, high school boy, had drunk a glassful of photo developing agent accidentally. The patient tried to expectolate it as much as he could. He developed severe buring sensation on the same day in mouth and hypopharynx; however, he had no dyspnea nor hoarseness.

　On physical examination it was revealed that he had marked pseudomembrane formation generally in oral cavity and hypopharynx. Electrolite balanceses were found to be normal.

　Intravenous fluid and massive intra muscular steroid hormon were started to be administered right away and this was followed by the insertion of a feeding tube.

　No distinct narrowing of the esophagus was observed until 6 weeks after the accident.

　Apparent demonstration of the stricture at mid-esophagus was found on the 7th week after the injury, which was proved by cine fluoroscopy and esophagoscopy.

　Mercury bouginage, the Maloney type, was started immediately and has been repeated every 2 weeks up to date. The patient is now in satisfactory condition with no clinical significance of stricture.