A Case of Acute Phlegmonous Esophagitis treated Surgically

Shin Nishiya, Atsushi Nagashima, Mitsuhide Kitano, Masakazu Doi, Shinobu Hayashi, Tomohisa Egawa, Yasuhiro Itou, Kazuhiko Sekine, Masayuki Shimizu and Hiroshi Yoshii*

Department of Surgery, Saiseikai Kanagawa-ken Hospital*

A 43-year-old man admitted for high fever, jaundice, dysphagia and elevated C-reactive protein was found in computed tomography (CT) to have diffuse wall thickening of the esophagus with intramural low density. Endoscopy showed the esophageal wall to be edematous and a blood culture indicated Klebsiella pneumoniae, yielding a diagnosis of acute phlegmonous esophagitis. After intravenous antibiotics, he improved but experienced dysphagia and odynophagia. Repeated chest CT and endoscopy following day 100 of hospitalization showed esophageal stenosis and extraluminal barium leakage. On day 126, we conducted right hemicolic interposition for esophageal reconstruction. The postoperative course was uneventful and he was discharged on postoperative day 54.

Key words
phlegmonous esophagitis

Reprint requests
Shin Nishiya Department of Surgery, Saiseikai Yokohama-shi Tobu Hospital
3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, 230-0012 JAPAN

Accepted
March 28, 2007

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