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患者王某,男,58岁,工人。患者近2年来感吞咽不适,伴胸骨后阵发性疼痛,无明显进行性加重,无呕吐及腹痛,食欲正常。1年前在其他医院做食管镜检查2次,均诊为“食管炎”,曾服多种药物治疗,效果欠佳。查体:一般情况可,皮肤粘膜及浅表淋巴结无异常,头颈、心肺未及异常,腹平软,肝脾未及,无包块。辅检:血、尿、粪三大常规及血沉、血脂、血糖、肝功、血生化、心电图均未见异常。全消化道钡透提示:食管癌。余肠段未见异常。食管镜检查:进镜42cm见贲门舒缩不匀,粘膜焰红色,食管下段38～36cm处粘膜环形糜烂,覆白苔,呈颗粒样增生。提示:食管溃疡。涂片镜检未见癌细胞。于入院第20天行开胸探查术。术中发现食管下端位于肺下静
Patient Wang, male, 58 years old, worker. Patients swallowing discomfort in the past 2 years, with paroxysmal paroxysmal pain, no significant progressive increase, no vomiting and abdominal pain, normal appetite. A year ago in other hospitals do esophagoscopy 2 times, were diagnosed as “esophagitis”, had served a variety of drug treatment, the effect is not good. Physical examination: the general situation can be, no abnormal skin and mucous membrane and superficial lymph nodes, head and neck, cardiopulmonary and anomalies, abdominal soft, liver and spleen not yet, no mass. Auxiliary examination: blood, urine, feces and the three major ESR, blood lipids, blood glucose, liver function, blood biochemistry, ECG were normal. Barium through the whole digestive tract tips: esophageal cancer. I am no abnormal bowel segment. Esophagoscopy: Into the mirror 42cm see Cardiac Shu Shu uneven, mucosal flame red, the lower esophagus 38 ~ 36cm at the mucosal ring erosion, covered with white moss, was pellet-like hyperplasia. Tip: Esophageal ulcer. Pap smear no cancer cells. On the 20th day of admission, open thoracotomy. Intraoperative esophageal found in the lower lung is quiet