Dados do Trabalho

Título

Dissecans Esophgitis of Probable Fungal Etiology: A Case Report

Apresentação do Caso

Esophagitis Dissecans (EDS) is a rare form of chronic esophagitis, distinguished by typically whitened mucosa with or without bleeding and the feature of cracks and vertical circle. In 1997, Ponsot and his associates suggested the name of “Chronic Esophagitis Dissecans” and ever since, few cases were described in the literature. Currently Upper Digestive Endoscopy (UDE) is the main tool for the early EDS diagnosis. Furthermore, the author reports a case of a young adult individual, previously salutar with no comorbidity who presented na EDS diagnosis within its probable cause associated to the loss of vascular sub mucous component.

Discussão

The patient, a 30-year-old male seeks medical care reporting long-term burning epigastralgia and the recent worsening of the pain intensity and stress increase. The patient denies feeling bowel constipation, effort for evacuating or haematochezia. The patient also denies fever, vomit, weight loss or arthralgias. His physical exams didn’t attest skin lesions, lymph nodes enlargement or any other abnormalities. In the past even without endoscopic or lab diagnosis he has self-medicated in order to treat Helicobacter pylori. In childhood he was diagnosed with Hepatitis B at 11 years old and malaria at 12. In his family history the author’s attention is drawn to several cases of malignant neoplasia in first degree relatives: grandmothers who had lymphoma and breast cancer and grandfathers who had prostate and lung cancer. By that moment an UDE was requested and it revealed mid third scaling off esophagitis with moderate distal third edematous component. Slight enanthematous antral endoscopic gastritis with slight erosive component and elevated antrum. At the moment, some corpus and gastric antrum biopsies were done with Helicobacter pylori research, alongside with serial biopsies from the proximal, medium and distal esophagus. The astral gastric portion presented results compatible with chronic gastritis with multifocal bowel metaplasia; therefore in gastric corpus the results were normal, besides the Helicobacter
pylori research showing negative for both portions. The microscopic biopsies exam showed absence of dysplasia and magnitude in all the analyzed samples.

Comentários finais

Of treatment was Pantoprazole, Fluconazole and Nistatine oral. Even though the UDE shows esophagitis and scaling-off process, the clinic course is conducive and the complete remission of the inflammatory aspect of the mucosa.

Palavras-Chave

Chronic Esophagitis; Esophagitis Dissecans;

Área

Endoscopia - Endoscopia digestiva alta