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The Usefulness of Magnetic Resonance Imaging in the Management of Acute Phlegmonous Esophagitis

Acute phlegmonous esophagitis is a rare life-threatening disease that often requires surgical intervention in case of complications, including esophageal abscess, perforation, or mediastinitis. We present a case of acute phlegmonous esophagitis, in which magnetic resonance imaging (MRI) proved usefu...

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Autores principales: Shimizu, Motohiro, Adachi, Hiroshi, Sai, Kenichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417366/
https://www.ncbi.nlm.nih.gov/pubmed/37568962
http://dx.doi.org/10.3390/diagnostics13152600
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author Shimizu, Motohiro
Adachi, Hiroshi
Sai, Kenichi
author_facet Shimizu, Motohiro
Adachi, Hiroshi
Sai, Kenichi
author_sort Shimizu, Motohiro
collection PubMed
description Acute phlegmonous esophagitis is a rare life-threatening disease that often requires surgical intervention in case of complications, including esophageal abscess, perforation, or mediastinitis. We present a case of acute phlegmonous esophagitis, in which magnetic resonance imaging (MRI) proved useful in planning the treatment strategy. An 89-year-old woman was admitted to the emergency department with painful swallowing and respiratory distress. She was diagnosed with acute phlegmonous esophagitis and a hypopharyngeal abscess based on computed tomography (CT) findings. However, there was a discrepancy between the clinical course and CT findings. Given the improvement of the patient’s condition with conservative treatment with ampicillin/sulbactam, the CT findings suggested an apparent abscess due to increased esophageal wall thickness. However, MR diffusion-weighted images showed a slightly high-intensity signal, suggesting that the enlargement was due to edema rather than an abscess. The patient recovered successfully following conservative treatment. Thus, our findings demonstrate the utility of MRI in the treatment planning of acute phlegmonous esophagitis, especially in cases with unreliable contrast-enhanced CT findings. However, future studies are warranted to explore the utility of MRI in the management of such cases.
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spelling pubmed-104173662023-08-12 The Usefulness of Magnetic Resonance Imaging in the Management of Acute Phlegmonous Esophagitis Shimizu, Motohiro Adachi, Hiroshi Sai, Kenichi Diagnostics (Basel) Interesting Images Acute phlegmonous esophagitis is a rare life-threatening disease that often requires surgical intervention in case of complications, including esophageal abscess, perforation, or mediastinitis. We present a case of acute phlegmonous esophagitis, in which magnetic resonance imaging (MRI) proved useful in planning the treatment strategy. An 89-year-old woman was admitted to the emergency department with painful swallowing and respiratory distress. She was diagnosed with acute phlegmonous esophagitis and a hypopharyngeal abscess based on computed tomography (CT) findings. However, there was a discrepancy between the clinical course and CT findings. Given the improvement of the patient’s condition with conservative treatment with ampicillin/sulbactam, the CT findings suggested an apparent abscess due to increased esophageal wall thickness. However, MR diffusion-weighted images showed a slightly high-intensity signal, suggesting that the enlargement was due to edema rather than an abscess. The patient recovered successfully following conservative treatment. Thus, our findings demonstrate the utility of MRI in the treatment planning of acute phlegmonous esophagitis, especially in cases with unreliable contrast-enhanced CT findings. However, future studies are warranted to explore the utility of MRI in the management of such cases. MDPI 2023-08-04 /pmc/articles/PMC10417366/ /pubmed/37568962 http://dx.doi.org/10.3390/diagnostics13152600 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Interesting Images
Shimizu, Motohiro
Adachi, Hiroshi
Sai, Kenichi
The Usefulness of Magnetic Resonance Imaging in the Management of Acute Phlegmonous Esophagitis
title The Usefulness of Magnetic Resonance Imaging in the Management of Acute Phlegmonous Esophagitis
title_full The Usefulness of Magnetic Resonance Imaging in the Management of Acute Phlegmonous Esophagitis
title_fullStr The Usefulness of Magnetic Resonance Imaging in the Management of Acute Phlegmonous Esophagitis
title_full_unstemmed The Usefulness of Magnetic Resonance Imaging in the Management of Acute Phlegmonous Esophagitis
title_short The Usefulness of Magnetic Resonance Imaging in the Management of Acute Phlegmonous Esophagitis
title_sort usefulness of magnetic resonance imaging in the management of acute phlegmonous esophagitis
topic Interesting Images
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417366/
https://www.ncbi.nlm.nih.gov/pubmed/37568962
http://dx.doi.org/10.3390/diagnostics13152600
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