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Abstract: A 45-year-old middle-aged male patient presented with retrosternal stabbing pain when swallowing after eating fish pot 2 days ago, thought it was caused by accidentally swallowing a fish spike, and took sour vinegar and swallowed steamed buns, but the pain became more severe, and through gastroscopy, it turned out to be an esophageal ulcer, and then after giving his medication orally for 2 weeks, the patient’s painful swallowing symptoms disappeared, and endoscopy showed that the patient’s esophageal ulcer basically healed.
Basic information】Male, 45 years old
Disease Type】Multiple esophageal ulcers
Hospital】Liaocheng Second People’s Hospital
Date of consultation】March 2022
Treatment plan】Medication (pantoprazole sodium enteric solution tablets, thioglycollate aluminum suspension gel)
Treatment period】2 weeks of outpatient treatment, regular follow-up
Treatment effect] Endoscopic healing of esophageal ulcer, disappearance of stinging sensation when swallowing
I. Initial consultation
When I came to the clinic early this morning, there was a patient waiting at the door with a painful face and hoarse voice, and I asked the patient about the painful swallowing after eating fish 2 days ago, and I felt hot in my mouth and swallowed it directly. He was afraid to continue his treatment at home and came to the hospital for examination.
II. Treatment history
The patient had painful swallowing for 2 days, with a short course and obvious causative factors. Due to inappropriate treatment measures taken at home, treatment was delayed and aggravated, and esophageal mucosal injury was considered. After perfecting gastroscopy, the results showed that the patient had multiple ulcers in the middle esophagus with white moss, with an area of about 0.6cm×0.6cm, 0.5cm×0.5cm, and 0.3cm×0.3cm, with clear borders. The patient was initially diagnosed to have multiple ulcers in the esophagus with a large area, mostly considered to be due to scalding, and was advised to have a semi-liquid diet and avoid eating acidic, spicy and irritating foods, and was also given pantoprazole sodium enteric tablets and thioglycollate aluminum suspension gel for oral administration.
III. Treatment effect
After 14 days of oral treatment with pantoprazole sodium enteric tablets and aluminum thioglycollate suspension gel, the patient’s painful swallowing symptoms basically disappeared and he returned to normal diet. 2 months later, the gastroscopy was repeated and the original esophageal ulcer was healed with smooth mucosa.
IV. Precautions
I am very glad that the patient’s condition has improved, but I still need to advise the patient to pay attention to a liquid or semi-liquid diet in the early stage of complete esophageal recovery, avoid spicy, sweet and hempy and irritating foods, eat too fast, swallow too much, and avoid eating too hot food. If you suspect that you have accidentally swallowed a foreign body, such as a fish spike or a chicken bone, you should not handle it at home by yourself. It is better to seek medical attention in time to avoid the foreign body from penetrating too deeply and causing more damage and combined infection.
V. Personal insight
Painful swallowing is often encountered in normal life, such as the most common tonsillitis, the location of this pain is more on the top, and some pain behind the sternum, most of them are related to improper eating, there are hot soup burns, there are hard food scratches, there are accidental swallowing of fish spikes, chicken bones, dentures, mostly caused by swallowing when eating.
In this case, if the patient has scalded esophagus or other scratches, drinking vinegar by oneself can aggravate the inflammatory reaction of trauma, deepen the depth of esophageal ulcer and enlarge the area of ulcer, and cause vascular damage and vomit blood. Therefore, we need to remind all friends, if there is painful swallowing, similar to food embolism, do not panic, promptly go to the hospital for examination and standardized treatment, the symptoms will be quickly controlled, avoid using some hearsay “prescription” to avoid aggravating the disease, delaying the treatment time.