エンドウ　シュンジ   Shunji Endo   遠藤　俊治    所属   川崎医科大学  医学部 臨床医学　消化器外科学    職種   准教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	A Case of Corrosive Esophagitis in Lao People's Democratic Republic
掲載誌名	正式名：International surgery 略　 称：Int Surg ISSNコード：00208868
掲載区分	国外
巻・号・頁	103(5-6),pp.300-304
著者・共著者	Shunji Endo, Ryoko Hirayama, Tran Van Nang, Yasuyo Umeno, Aiko Otani, Hiroe Komori, Yoshiko Kawaguchi, Ayako Iwasaki, Kittiphanh Akkharath, Mamoru Akita, Kentaro Ishida and Hideto Yoshioka
担当区分	筆頭著者
発行年月	2018/05
概要	Introduction: Corrosive esophagitis is often caused by the intake of alkaline or acidic substances. Esophageal stenosis is the most important late complication of corrosive esophagitis. In Laos, where Western medical care is available in few locations, treatment for esophageal stenosis is challenging. We report on a patient who was treated in Laos. Case Presentation: In Laos, an 18-year-old woman attempted to commit suicide by drinking an acidic detergent. Sixteen months later, she consulted a district hospital in Laos, which is supported by a Japanese nonprofit organization, with a chief complaint of dysphagia. An upper gastrointestinal series demonstrated severe stenosis of her thoracic esophagus. She underwent open laparotomy for gastrostomy with a urinary catheter to improve her nutritionally poor condition; the operation was performed by a Japanese surgeon with Lao medical staff. Through the gastrostomy, she injected liquid food by herself. Gradually she became unable even to drink water. Because we could not obtain any devices for esophageal dilatation in Laos, balloon dilatation catheters were donated from Japan. Twenty-three months after the injury, the endoscopic balloon dilatation for esophageal stenosis was performed by a Japanese physician, who also taught local physicians how to use the device. The patient's esophagus was as narrow as a pinhole at 20 cm from the incisors. Repeated balloon dilatation by local physicians enabled her to consume solid food orally. Conclusion: Corrosive esophagitis combined with stenosis is often difficult to treat. The Lao patient was successfully treated by a combination of local and foreign medical staff.