普卢默-文森综合征:罕见病例报告

Mukesh Kumar Saphi, Yalla Sai Vijaya Durga, Sunny Kumar Yadav, Krishnadev Shah, Amit Kumar
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摘要

普卢默-文森综合征又称帕特森-凯利综合征,其特征是典型的吞咽困难、缺铁性贫血和食管蹼三联征。该综合征与环状带后癌的发病率增加有关,为进行监测,建议在全身麻醉下进行内窥镜检查。这是一例患有普卢默-文森综合征的 74 岁女性患者,她成功地接受了萨瓦里-吉利尔德(SG)扩张术或食管扩张术。患者有长期缺铁性贫血的临床病史,从 10 年前开始出现吞咽固体食物困难的缓慢进展,左侧和右侧有舌咽神经褶、双侧杓状舌骨褶,过去 10 年来一直有吞咽困难。此外,患者还伴有腹痛,并向上腹放射,发热、畏寒和全身僵硬。内窥镜检查是在全身麻醉的情况下进行的,结果显示颈部食管处有食管网。实验室数据调查显示,红细胞计数为 209 万/立方厘米,血红蛋白为 6.6 克/分升,血清铁为 7 微克/分升。医生给患者开了 Inj.Orofer-XT 100 毫克,每天静脉注射蔗糖铁补充剂,持续 15 天;Inj.泮托拉唑 40 毫克,每天一次,持续 1 周。曲马多注射液 1 安培,饭前 30 分钟服用。她的贫血状况有所改善,但吞咽困难没有改善。为了治疗吞咽困难,在透视下通过内窥镜进行了萨瓦里-吉利尔德(SG)扩张术,该手术只进行了一次,通过破坏网状结构连续增加了直径,没有出现任何并发症。SG扩张术后,患者的吞咽困难很快就得到了缓解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Plummer-Vinson Syndrome: A Rare Case Report
Plummer-Vinson syndrome, also called Paterson-Kelly syndrome, is characterized by the classic triad of dysphagia, iron-deficiency anemia, and esophageal webs. This syndrome is associated with an increased incidence of post-cricoid carcinoma and for surveillance, an endoscopy is recommended under general anesthesia. This was a case of 74-year-old woman with Plummer-Vinson Syndrome who was successfully treated with Savary-Gilliard (SG) dilation or Esophageal dilation. The patient had a long-standing clinical history of iron deficiency anemia with slow progression of dysphagia of solid food from 10 years and glossoepiglotic fold, aryepiglottic fold bilaterally arytenoid on the left & right side and had experienced difficulty in swallowing for the past 10 years. Along with this patient is having abdominal pain radiating to the epigastrium region and fever with chills & rigors. An endoscopy examination was conducted under general anesthesia and revealed the esophageal web at the level of the cervical esophagus. Laboratory data investigation shows an RBC count of 2.09 million/cumm, haemoglobin of 6.6 gm/dl%, and serum iron of 7µg/dl. The patient was prescribed Inj. Orofer-XT 100 mg intravenous iron sucrose supplement daily for 15 days, Inj. Pantoprazole 40 mg daily for 1 week, Inj. Tramadol 1amp whenever required and Syp.Sucralfate 15 ml 30 minutes before food. Her anemia condition was improved but dysphagia did not improve. To treat dysphagia the Savary-Gilliard (SG) dilation was done under fluoroscopy by endoscopically a single session was performed that serially increased the diameter by disrupting the web without any complication. After SG-dilation, the patient's dysphagia resolved shortly after the treatment.
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