Moderate inhalation injury

Introduction Moderate inhalation injury refers to more than tracheal carina, including damage to the throat and trachea.

Cause

(1) Causes of the disease

Syphilis is a chronic infectious disease caused by Treponema pallidum, which is a type of sexually transmitted diseases. It is a systemic infection at the beginning and can involve any organ and tissue during development. Esophageal syphilis is extremely rare, mainly for stage III syphilis.

(two) pathogenesis

Esophageal syphilis is no different from syphilitic lesions in other parts of the body. In addition to the gum-like swelling, syphilis is mainly a vascular lesion from beginning to end. Late syphilis is an inflammatory change and necrosis caused by occlusive endarteritis of the terminal arterioles and arterioles. In general, stage III syphilis lesions manifest as submucosal gums or diffuse inflammation with tissue destruction, both of which can lead to erosion and ulceration leading to scarring stenosis.

an examination

Related inspection

Tracheal CT scan of tracheal aspiration

Dysphagia is the most common symptom of esophageal syphilis. It is mostly painless. It is characterized by long course and slow progress, which is different from esophageal cancer. When the lesion progresses, eating fluid can also cause difficulty in swallowing and sensation of post-sternal pressure, which can result in weight loss, dehydration, anemia, and cachexia due to insufficient intake. Once the gum is swollen, the trachea (bronchial) esophageal fistula will cough every time you eat. In addition, other symptoms of esophagitis and obstruction may also occur.

Differential diagnosis

Need to be identified with the following symptoms:

Suppurative esophagitis

Suppurative esophagitis is the most common mechanical damage caused by foreign bodies. Bacteria multiply in the esophageal wall, causing local inflammatory exudation, varying degrees of tissue necrosis and pus formation, and may also be a wide range of cellulitis.

2. Esophageal tube

Patients with esophageal tuberculosis generally have pioneering symptoms of tuberculosis in other organs, especially tuberculosis. The symptoms of the esophagus itself are often confused or concealed by other organ symptoms, so that they cannot be discovered in time. According to the pathological process of tuberculosis, the early stage of infiltration may have symptoms of fatigue such as fatigue, hypothermia, and increased erythrocyte sedimentation rate, but there are also symptoms that are not obvious. Following swallowing discomfort and progressive dysphagia, often accompanied by persistent throat and retrosternal pain, increased when swallowed. Ulcer-type lesions are often characterized by pain during swallowing. Food spillage into the trachea should take into account the formation of tracheoesophageal fistula. Dysphagia suggests that lesion fibrosis causes scarring.

3. Fungal esophagitis

The clinical symptoms of fungal esophagitis are mostly atypical, and some patients may have no clinical symptoms. Common symptoms are swallowing pain, difficulty swallowing, upper abdominal discomfort, post-sternal pain, and burning sensation. In the severe sternum, there is a knife-like colic, which can radiate to the back like angina. Candida esophagitis can cause severe bleeding but is not common. Untreated patients may have epithelial shedding, perforation, or even disseminated candidiasis. Perforation of the esophagus can cause mediastinal inflammation, esophageal fistula, and esophageal stricture. Patients with persistent high fever neutropenia should be examined for the presence of disseminated acute candidiasis such as skin, liver, spleen and lung.

4. Viral esophagitis

HSV infection of the esophagus often has nasal and herpes. The main symptom is swallowing pain. Pain often worsens when ingesting food, and the patient descends slowly in the esophagus after swallowing. A small number of patients with dysphagia as the main symptom, mild infection can be asymptomatic.

Dysphagia is the most common symptom of esophageal syphilis. It is mostly painless. It is characterized by long course and slow progress, which is different from esophageal cancer. When the lesion progresses, eating fluid can also cause difficulty in swallowing and sensation of post-sternal pressure, which can result in weight loss, dehydration, anemia, and cachexia due to insufficient intake. Once the gum is swollen, the trachea (bronchial) esophageal fistula will cough every time you eat. In addition, other symptoms of esophagitis and obstruction may also occur.

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