Suppurative esophagitis
Introduction
Introduction to suppurative esophagitis Syphilitic esophagitis (pyogenicesophagitis) is a purulent inflammation caused by purulent bacteria invading the esophageal mucosa in the case of damage to the esophageal mucosa. It is often caused by esophageal mucosal damage caused by esophageal foreign body or device examination. Suppurative esophagus Inflammation can be a localized lesion, most of which form one or more submucosal abscesses, and the abscess can be naturally healed after drainage to the esophageal lumen. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: tracheoesophageal fistula
Cause
Causes of suppurative esophagitis
(1) Causes of the disease
The pathogens of infection are mostly Gram-positive cocci and Gram-negative bacilli in the pharynx. In the AIDS patients, the formation of esophageal ulcer associated with Nocardia has been reported. The infection caused by injury generally occurs at or near the injury site, and the immune function declines. The infection is more common in the esophagus. In the lower part, the infection can be more limited. It can manifest as one or several small abscesses. It can also be a wide range of cellulitis, involving the surrounding tissues of the esophagus, and forming a fistula in the mediastinum or adjacent organs.
(two) pathogenesis
Any condition that causes the esophageal mucosa to collapse and allow pathogenic bacteria to invade the esophageal wall can lead to suppurative esophagitis. Among them, mechanical damage caused by foreign bodies is the most common, and bacteria accumulate in the esophageal wall and cause local exudation. Different degrees of tissue necrosis and pus formation.
Prevention
Suppurative esophagitis prevention
It prevents the pathogenic bacteria caused by the damage of foreign body and mechanical damage to the esophageal mucosa from invading the esophageal wall and forming inflammation.
Complication
Suppurative esophagitis complications Complications of tracheoesophageal fistula
Infection can also spread to cause esophageal cellulitis, involving the surrounding tissues of the esophagus, such as the mediastinum and adjacent organs to form a fistula.
Symptom
Suppurative esophageal inflammatory symptoms Common symptoms Dysphagia, high fever, swallowing pain, sternal pain, sepsis, eating difficulties, chills
The clinical manifestation depends mainly on the extent of the infection and the patient's reactivity. In the case of limited infection, the abscess can be worn out and drained to the esophageal lumen and heal itself. The patient is asymptomatic or has only neck pain or sore throat. In addition to neck pain or swallowing pain, larger patients may have dysphagia, post-sternal pain, chills, fever and other symptoms. Patients with higher responsiveness may often have high fever, and a small number of patients may develop sepsis and corresponding performance.
Examine
Examination of suppurative esophagitis
1. Blood routine: the total number of white blood cells and the number of neutrophils increased.
2. Esophageal secretion bacterial culture: pathogenic bacteria were found.
3. Endoscopy: common esophageal mucosa congestion, edema, ulcers, pseudomembranous and local fragility increased.
4. Endoscopic biopsy pathology: If more bacteria are seen in the submucosa, a diagnosis can be established.
Diagnosis
Diagnosis and differentiation of suppurative esophagitis
diagnosis
1. History of injury caused by esophageal foreign body or device examination.
2. Clinical manifestations such as fever and post-sternal pain.
3. Abscess and other lesions were found under endoscopy.
Differential diagnosis
Suppurative esophagitis often occurs in a state of low systemic immunity, and can be combined with other pathogens such as viruses and fungi.
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