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Diphtheria esophagitis
Last reviewed: 23.04.2024
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Diphtheria esophagitis occurs with an erased clinical picture and, as a rule, remains unnoticed against the background of pronounced phenomena of diphtheria of the pharynx or larynx.
Esophageal infection by diphtheria infection refers to rare diseases. It can occur in severe diphtheria of the pharynx with spread to the hypopharyngs and esophagus. Usually, the upper parts of the esophagus are affected, but there are cases of damage to the lower third of the esophagus and even the mucous membrane of the stomach.
[Symptoms of diphtheria esophagitis
With a slow development of the disease, diphtheria esophagitis may manifest as sudden vomiting during meals and the presence in the emetic masses of dirty gray diphtheria films with an unpleasant odor, covered with blood veins. Simultaneously there are pains in the esophagus and aggravation of the general condition of the patient.
In the case of fibro-esophagoscopy, the walls of the esophagus are covered with dark gray or yellowish coatings, tightly welded to the underlying tissue, bleeding when they are separated, sometimes ulcerated and necrotic wall surfaces are determined. In the removed films, the Klebs-Leffler sticks are revealed.
Evolution of diphtheria esophagitis is less dependent on the esophagus, rather than on the severity of the diphtheria infection.
Complications arise in the form of paralysis of the esophagus and its strictures. Usually cicatricial esophageal stenosis, caused, for example by chemical burn, is localized over physiological constrictions, with diphtheria esophagitis they usually arise in the places of these constrictions and at its ends - upper and lower.
Distinguish between early and late postdifteria strictures of the esophagus. The early ones appear in 3 weeks from the onset of the disease and do not differ in its pronounced obstruction (it is possible to pass through strictures of liquid or mushy food). Late strictures cause a significant narrowing of the lumen of the esophagus, sometimes not exceeding 1-3 mm, extending in length by 1-3 cm.
Where does it hurt?
Diagnosis of diphtheria esophagitis
Diagnosis of both diphtheritic esophagitis, and its consequences in the form of paralysis and strictures is quite difficult. Usually the first is established indirectly, but the presence of neuritic paralysis of the soft palate and the muscles of hypofaring, stenosis - according to the characteristic clinical picture of the obstruction of the esophagus and the data of esophagoscopy of the radiographic examination.
What do need to examine?
What tests are needed?
Who to contact?
Treatment of diphtheria esophagitis
Treatment of diphtheria esophagitis is included in the general treatment of diphtheria infection - serotherapy, penicillin therapy, stimulation of the functions of vital organs, analgesics, sedatives; sparing liquid diet, chilled mucus broths with a suspension of penicillin; control of kidney function, with diphtheria polyneuritis - preparations of B vitamins, etc. In cicatricial stenosis of the esophagus and inability to feed naturally, gastrostomy and bougie of the esophagus are performed to expand its stricture.