The differential for chest pain: when the most common cause is not the answer-a case of de novo esophageal bezoar

Surgical Case Reports

Daniel Roubik¹  Kevin Climaco¹  Robert Gorrell¹ 

[1] General Surgery Department, William Beaumont Army Medical Center, El Paso, TX, USA;

关键词: Esophageal;    Bezoar;    Chest;    Pain;    Achalasia;    Perforation;   

DOI  :  10.1186/s40792-021-01311-7

来源: Springer

【 摘 要 】

BackgroundHaving a broad differential and knowing how to manage the different possibilities in a patient with chest pain is important. Esophageal bezoars are rare entities and are even less common in patients without any recent hospitalizations, known achalasia, or nasogastric tubes. Despite their rarity, having it in one’s differential, and knowing how to manage it is important.Case presentationThis case presents a patient with mega-esophagus secondary to an esophageal bezoar; and runs through the gamut of morbid chest pathophysiology, its differential, work-up, and management. The case is interesting in that the patient’s initial presentation brings to mind a bevy of feared chest issues to include myocardial infarction, dissection, pulmonary embolus, achalasia, and perforation.ConclusionThis clinical case highlights more than just the rare diagnosis of esophageal bezoar. It also goes through initial resuscitation, key concerns, “can’t miss diagnoses”, and finally discusses the feared end state of an esophageal perforation.

【 授权许可】

CC BY