心筋梗塞様症状にて発症した急性食道胃蜂巣炎の1例

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  • A CASE OF ACUTE ESOPHAGOGASTRIC PHLEGMON WITH SYMPTOMS SEEMED LIKE MYOCARDIAL INFARCTION

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A patient with esophagogastric phlegmon who presented with symptoms seemed like myocardial infarction and had an acute clinical course was successfully treated by peritoneal drainage and incision drainage.<br> A 49-year-old man was seen at the department of internal medicine in our hospital because of pain in the aterior thoracic region. Myocardial infarction was suspected, but no abnormal findings were revealed on an angiography. The pain abruptly extended to the upper abdomen and peritoneal sign developed. So the patient was referred to the department for operation. Preoperative CT revealed diffuse and whole-circumferential thickening of the wall ranging from the thoracic esophagus to entire stomach, especially a large volume of gas in he wall of the stomach. Based on these findings, a diagnosis of peritonitis due to esophagogastric phlegmon was made and the patient was operated on. During operation, a thickenin gof the gastric wall and draiange of sticky pus from the incision for drainage were confirmed. Postoperative course was uneventful and the patient was discharged from the hospital on 70th postoperative day.<br> This disease is often fatal and early diagnosis and early treatment are essential. Upon operation, it is important to select appropriate operative proceudre case by case, and CT is a useful tool in preoperative diagnosis. and we have realized keenly the significance of taking into account the possible presence of the disease for acute abdomen.

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