PDF(Pubmed)
Abstract：
Numerous pulmonary conditions, such as aspiration pneumonia and acute respiratory distress syndrome (ARDS), may result from aspiration of gastric or oropharyngeal contents passing into the lower respiratory tract. ARDS is a type of diffuse lung injury that is distinguished by the abrupt onset of extensive pulmonary inflammation accompanied by the failure of multiple organ systems. Systemic sclerosis is an uncommon connective tissue disorder that presents with skin thickening, the etiology of which remains unknown. Esophageal luminal dilatation is observed in the distal third of the esophagus in most cases of systemic sclerosis. This dilatation is primarily attributed to the greater abundance of smooth muscle fibers in this area. Here, we present the case of a 70-year-old female patient who was diagnosed clinically with diffuse systemic sclerosis and fulfilled the 2013 European League Against Rheumatism/American College of Rheumatology classification criteria. She had esophageal dilatation, with an esophageal luminal diameter measured at the upper, middle, and lower thoracic esophagus of 2.5 cm, 2.5 cm, and 3.5 cm, respectively. The patient was admitted to the intensive care unit (ICU) due to ARDS from aspiration pneumonia. Our patient\'s complicated condition at the time of ICU admission with ARDS secondary to aspiration pneumonia was primarily due to esophageal dilatation and reflux. Aggressive anti-reflux pharmacotherapy and bed elevation may be beneficial in preventing pulmonary injury caused by aspiration. Esophageal complications are common in such patients and can have a substantial impact on the prognosis and quality of life. Regular medical attention is necessary to identify and manage any potential issues.
摘要：
许多肺部疾病，如吸入性肺炎和急性呼吸窘迫综合征（ARDS），可能是由于胃或口咽内容物进入下呼吸道而引起的。ARDS是一种弥漫性肺损伤，其特征是突然发作的广泛肺部炎症伴随着多器官系统的衰竭。系统性硬化症是一种罕见的结缔组织疾病，表现为皮肤增厚，其病因尚不清楚。在大多数系统性硬化症病例中，在食管远端三分之一处观察到食管管腔扩张。这种扩张主要归因于该区域平滑肌纤维的更丰富。这里,我们介绍1例70岁女性患者,临床诊断为弥漫性系统性硬化症,符合2013年欧洲抗风湿病联盟/美国风湿病学会分类标准.她有食道扩张症,食道内腔直径在上部测量，中间,和下胸段食管2.5厘米，2.5cm,和3.5厘米，分别。由于吸入性肺炎引起的ARDS，患者被送往重症监护病房（ICU）。我们的患者在入住ICU时并发ARDS继发于吸入性肺炎主要是由于食管扩张和反流。积极的抗反流药物治疗和床抬高可能有助于防止误吸引起的肺损伤。食管并发症在此类患者中很常见，并且可能对预后和生活质量产生重大影响。定期就医是必要的，以识别和管理任何潜在的问题。
