再発性嚥下性肺感染症に対して経皮内視鏡的胃痩造設術が有効であった逆流性食道炎の1例

Abstract

A case of reflux esophagitis with recurrent aspiration pneumonia treated with percutaneous endoscopic gastrostomy (PEG) is reported. The patient was a 79-year -old female who was admitted to Oyodo Municipal Hospital because of anorexia, fever, and productive cough on June 23, 1994. A Plain film of the chest disclosed a pulmonary abscess and pneumonia mainly in segment 6 of the right lung. An upper G I series and esophagos- copy showed esophageal hiatal herniation (sliding type) and stenosis caused by reflux esophagitis. The patient was treated with antibiotics for the pulmonary infection. However, she had a relapse of the pulmonary infection. However, she had a relapse of the pulmonary infection after the antibiotics were stopped. PEG was performed to allow tubal feeding. The gastrostomy tube was opened at bed time in order to prevent microaspiration of gastric and duodenal juices. The pulmonary infection did not recur after PEG was performed. In this patient, PEG was useful in the treatment of reflux esophagitis with recurrent aspiration pneumoma.