대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Chief Complaint

Foreign body sensation, chest pain

Definitive Diagnosis

Acute phlegmonous esophagitis

Past History

Unknown

Reviewy

A rare, life-threatening disorder (mortality rate: 42%)
By bacterial infection of the submucosal and muscularis layers of the digestive tract due to damage to the intestinal tract
Stomach: m/c involved site
Predisposing factors:alcoholism, old age, malnutrition with a low albumin level, and uncontrolled diabetes
Findings
Intramural, circumferential, low-attenuation area of the esophagus surrounded by an enhanced peripheral rim
Histopathological features
Thickening of the submucosa and infiltration of neutrophils and plasma cells with intramural hemorrhage
Necrosis, thrombosis of the submucosal blood vessels
Abscess in the submucosal and muscularis layers of the esophagus
Treatment
Systemic antibiotic administration
Surgical resection
Extensive phlegmonous esophagogastritis, since this involves esophageal necrosis, esophageal stricture progression, gastric mucosa atrophy, and acute peritonitis

Keywords