Hospital therapy. Etiology, pathogenesis, clinical picture of acute esophagitis (most important)

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Hospital therapy. Etiology, pathogenesis, clinical picture of acute esophagitis (most important)

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34. Etiology, pathogenesis, clinical picture of acute esophagitis

Acute esophagitis is an inflammatory lesion of the mucous membrane of the esophagus lasting from several days to 2-3 months.

Etiology and pathogenesis. Etiological factors: infectious diseases, injuries, burns, poisoning, allergic reactions, nutritional errors.

Of the infectious agents, the most characteristic of acute esophagitis are diphtheria, scarlet fever, typhoid and typhus, influenza, parainfluenza, adenovirus infection, mumps.

Physical and chemical damaging factors are represented by ionizing radiation, chemical burns, hot and very cold food, and spices.

clinical picture. Catarrhal esophagitis is the most common form of acute esophagitis. It occurs against the background of errors in nutrition: when eating spicy, cold, hot dishes, with minor injuries, alcohol burns.

It is clinically manifested by burning and pain behind the sternum, forcing patients to refuse food for several days.

Endoscopically noted esophagitis I-II degree, x-ray - hyperkinesia of the esophagus.

Erosive esophagitis occurs with infectious diseases and allergies.

Clinical symptoms are similar to those of catarrhal esophagitis.

Hemorrhagic esophagitis is a rare clinical form of erosive esophagitis. The etiology is the same as in erosive esophagitis. Intense pain syndrome and hematemesis are clinically typical.

The clinic is dominated by dysphagia and intense pain, aggravated after eating, nausea, vomiting. With vomit, fibrin films are released, there may be hemoptysis.

Membraneous (exfoliative) esophagitis by etiology is chemical (burns of the esophagus), infectious.

In the clinic of severe membranous esophagitis, intoxication, dysphagia and pain syndrome prevail.

Necrotizing esophagitis is a rare form of acute inflammation of the esophagus. Its development is facilitated by reduced immunity in such serious diseases as sepsis, typhoid fever, candidiasis, end-stage renal failure.

The clinic is characterized by painful dysphagia, vomiting, general weakness, bleeding, frequent development of mediastinitis, pleurisy, pneumonia.

Septic esophagitis is a rare local or diffuse inflammation of the walls of the esophagus of streptococcal etiology or occurs when the mucosa is damaged by a foreign body, with burns, ulcers, and can pass from neighboring organs. Sometimes acute phlegmonous esophagitis occurs as a complication of any form of acute esophagitis, leading to purulent fusion of the walls of the esophagus.

The clinical picture is characterized by severe intoxication, high fever, pain behind the sternum and in the neck, vomiting. On examination, there is swelling in the neck, mobility in this part of the spine is limited. The position of the head is forced, with an inclination to one side. The disease often transforms into purulent mediastinitis.

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