Esophageal ulcer

Introduction It is an inflammatory lesion caused by different causes, which occurs in various segments of the esophagus, that is, the mucosal layer of the esophagus, the submucosa, and the muscle layer are destroyed. Specifically, it is an ulcer that occurs below the pharynx and above the dentate line. The normal esophagus is about 25-30 cm long. From the incisors to the upper end of the esophagus about 15 cm, to the end of the esophagus about 40-42 cm. There are also three physiological stenosis in the esophagus, which is a good site for foreign body retention and esophageal cancer. Clinically, the esophagus is often divided into three segments: upper, middle and lower. In addition to corrosive esophagitis; esophageal ulcers caused by other diseases occur mostly in the middle and lower segments of the esophagus.

Cause

An inflammatory lesion that occurs in various segments of the esophagus due to different causes, that is, the mucosal layer of the esophagus, the submucosa, and the muscle layer are destroyed. The stomach and duodenal mucosa are not only frequently exposed to high concentrations of gastric acid, but also affected by pepsin, microorganisms, bile salts, ethanol, drugs and all harmful substances. Helicobacter pylori is one of the main causes of digestive ulcers.

an examination

Related inspection

Electron endoscopy endoscopy microendoscopy fiberoptic endoscopy

In patients with esophageal ulcers, due to the stimulation of acidic gastric juice and eating, the following symptoms may occur:

(1) Pain in the lower part of the lower part of the sternum or in the upper part of the upper part. Pain often worsens after eating or drinking water, and can be released to the intersegmental area, left chest, or upwards to the shoulders and neck. Sometimes the pain is similar to coronary heart disease and angina. Should be identified. The method of identification can be determined by detailed medical history and physical examination, and the diagnosis is determined by electrocardiogram, esophageal barium meal and esophagoscopy.

(2) Difficulty in swallowing is also a common symptom. Difficulty in swallowing refers to the feeling of being blocked when eating and swallowing. At first, it is difficult to swallow the solid food. Later, as the disease progresses, even the liquid food will feel blocked. This is because the stimulation of food after eating a patient with esophageal ulcer can cause spasmodic contraction of the esophagus and difficulty in swallowing. In addition, chronic ulcers can cause local scarring and stenosis, which is also an important cause of difficulty in swallowing.

(3) Esophageal ulcer can also cause nausea, vomiting, belching and other symptoms, which is caused by the destruction of normal peristalsis of the esophagus.

(4) Anemia and weight loss can occur due to poor long-term eating.

Differential diagnosis

Common diseases that cause esophageal ulcers are: esophageal peptic ulcer, esophageal Crohn's disease, Behcet's disease, esophageal cancer, reflux esophagitis, corrosive esophagitis. In addition, esophageal tuberculosis, syphilitic esophagitis can also occur esophageal ulcers, these diseases caused by esophageal ulcers are often multiple superficial ulcers, and some are a single large ulcer, should be noted to identify when examining, especially the esophagus In the early stages of cancer, it is sometimes difficult to distinguish it from peptic ulcers. Pay special attention when checking. The above diseases are not difficult to make a diagnosis based on their respective clinical manifestations and pathological examinations. Sometimes the lesions are difficult to distinguish, and it is necessary to follow the observation repeatedly and perform multiple biopsy before making a correct diagnosis.

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