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A Typical Case of Esophagus Affection Caused by Scleroderma

Time:2022-10-21 00:08:40

Ms.Wang, 40, a patient of Scleroderma. Six years ago, she initiated such symptoms as swelling and stiffness with face, trunk and limbs. The color of both hands deepened and got pale or cyanosis at cold temperature. Then, both hand's skin became tight, stiff, bright and hard to pinch, plica vanished, painful joints with movement restricted or unmovable along with ulcer at fingertips and articular heads while the disease deteriorated. Especially in the recent four years, she developed such symptoms as heartburn, acid regurgitation, epigastric distention, belching and swallowing foods not smoothly, and even became aggravated progressively---from the condition that she had a hard time to eat dry foods initially to the condition later only able to have liquid diet. After meal, she felt foods retained behind her breastbone and backflowed frequently, even a bending posture would make her vomit of sour fluid. In the worst stage, she could only drink mild, and rice meal was a hard time for her. Along with reduced meal volume, her weight dropped gradually from the original 55kg down to less than 40kg. Hard to take care of herself, let alone working capacity. She saw many doctors and visited provincial hospitals and folk herbalists without any improvement before came to our department in September 2004. When diagnosing initially, she appeared obvious thin and suffering from anemia, tight and stiff skin all over, atrophia, restricted to open mouth or stick out of her tongue. The movement of joints at shoulders, elbows, wrists, knees, ankles and fingers were limited noticeably and some joints were stiff and unmovable. The contrast examination of upper digestive tract indicated stiff esophagus wall with obviously slack peristalsis. The transit time of barium meal was 58 seconds in standing position and there were still plenty of barium meals left in the esophagus after 10 minutes in lying position. The lower segment of esophagus was found narrow and some barium meal backflowed at the cardia. The laboratory report of blood routine examination indicated 80g/L of haemoglobin only. After comprehensive treatment for a period of time with Shenzhe Zhuyun Mixture, Yingpiling preparation and herbal medicinal broths as well as intravenous transfusion of Jiweiling Injection, supportive nourishment and Chinese traditional medicated bath, the patient’s condition showed improvement markedly. Specifically, the symptoms like acid regurgitation and heartburn started to relieve, foods swallowing smoother, increased appetite, better mind and strength, and wider range of motion after one week's hospitalization. And the condition improved further after one month's hospitalization--able to eat noodle and cake, obviously easy of acid regurgitation, heartburn and epigastric distention, looked not that pale as originally. Her weight increased to near 40kg, and she could basically to take care of her basic living activities. The laboratory examination indicated haematoglobin of 102g/L, the transit time of barium meal in standing position was 33 seconds and the narrow esophagus was improved too. So, she went out of hospital with prescribed administration of medicines. The telephone visit after three more months found the patient's condition was comparatively stable, no recurrence of original symptoms and her weight went up to 44kg with satisfactory efficacy.