J Yeungnam Med Sci.  2023 Oct;40(4):442-447. 10.12701/jyms.2023.00136.

Treatment of phlegmonous esophagitis in various patients: a case series

• Lee HS
• Lee CH
• Jeon YH

• KMID: 2547371
• DOI: http://doi.org/10.12701/jyms.2023.00136

Abstract

Acute phlegmonous esophagitis (APE) is a rare and fatal disease. Phlegmonous infection involves the submucosal layer and muscularis propria but not the mucosal layer. Because surgery is not the first treatment option for this disease, an accurate diagnosis is crucial. Herein, we report three cases of APE with various clinical features. All patients were successfully treated with antibiotics and appropriate medical procedures.

Keyword

Esophagitis; Phlegmonous esophagitis; Treatment of phlegmonous esophagitis

Figure

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  Fig. 1. (A) Enhanced chest computed tomography (CT) shows circumferential wall thickening of the esophagus with multiple air bubbles. (B) Esophagogastroduodenoscopy (EGD) reveals esophageal mucosal edematous change and an upper opening. (C) On hospital day 5, chest CT reveals improvements in esophageal wall thickening, submucosal air, and fluid collection. (D) The previous opening appears as a pseudolumen on follow-up EGD. (E) Esophagogram reveals no passage disturbance or leakage.

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  Fig. 2. (A) Circumferential esophageal wall thickening and submucosal fluid collection with pleural effusion on initial chest computed tomography (CT) image. (B) Edematous esophageal mucosa on initial esophagogastroduodenoscopy (EGD) image. (C) Chest CT on hospital day (HD) 18. Improved esophageal wall edema and submucosal fluid collection. (D) EGD on HD 12. Esophageal wall edema is improved, and esophageal varices are seen on follow-up EGD.

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  Fig. 3. (A) Diffuse edematous esophageal wall thickening on the initial chest computed tomography (CT). (B) Edematous esophageal wall on initial esophagogastroduodenoscopy. (C) Chest CT on hospital day (HD) 5 reveals increased edema and submucosal fluid collection in the esophageal wall compared with the previous CT. (D) Chest CT on HD 29 reveals decreased esophageal wall thickening and submucosal fluid collection compared with the previous CT.

Reference

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