最近,我们在内窥镜检查中发现1例食管内萝卜块,8d 内曾在几家医院先后误诊为食管癌。现将病历、诊治经过摘要报告如下患儿刘雪莲,女,13岁,学生.本院门诊以“食后即吐8d”之主诉拟诊为“食管炎”。经详细询问病史,患儿在8d 前因进食腌萝卜而产生咽下不畅,继之进食即吐.随即到当地医院检查,诊断为食管癌。后又赴西安几家医院检查.经 X 线吞钡透视及摄片,见食管中段阻塞、钡剂通过不畅,仍诊断为食管癌.诊治经过:1989年5月6日,用 Olympus SQ_(10)型纤维胃镜检查,见距门齿30cm 处食管内有一巨大异物堵塞管腔,用三爪钳夹持可上下活动,随之连同胃镜一并退出,见其是一块体积为2.5×2.0×2.0cm~3大小之萝卜块。再次进镜见粘膜糜烂,充血水肿,因进镜有阻力而未继续插镜。4d 后,(?)Olympus P_5型纤维胃镜重新检查,见门距齿28cm 处食管后壁有一面积约1.0×0.6cm~2之溃疡灶,周围有3处潮红斑,此段至贲门管腔狭窄,直径约1.2cm 左右,粘膜光软,蠕动正常,扩张良好.讨论:患儿误诊为食管癌有以下几点教训:①几家医院的初诊医师对病史的收集、分析不够全面,仅凭简单的“食后即吐”就草率做出诊断是不够恰当的;②过分相信 X 光检查,而忽视了考虑使用胃镜这个很有价值的手段;③忽视了在年龄上的鉴别诊断:据有关文献报道,食管癌多见于40岁以上男性,尤以60～70岁为 Recently, we found in the endoscopy 1 case of esophageal radish block, 8d has been misdiagnosed as esophageal cancer in several hospitals within 8d. Now medical records, diagnosis and treatment after the summary report is as follows Liu Xuelian children, female, 13 years old, the students outpatient clinic to “postprandial vomit 8d” chief complaint to be diagnosed as “esophagitis.” After detailed medical history, children with dysphagia due to eating pickled radish 8d, followed by eating vomit, then to the local hospital for examination, the diagnosis of esophageal cancer. After a visit to several hospitals in Xi’an. X-ray barium swallowed and radiography, see the middle of the esophagus obstruction, barium poor, is still diagnosed as esophageal cancer. After treatment: May 6, 1989, with Olympus SQ_ ( 10) fiber endoscopy, see 30cm away from the incisors have a large esophagus within the lumen to block the lumen, with the three-jaw clamp can be up and down activities, along with the gastroscope exit together, see it is a volume of 2.5 × 2.0 × 2.0 cm ~ 3 size radish block. See again into the mirror mucosal erosion, congestion and edema, because there is resistance into the mirror and did not continue to insert the mirror. 4d, (?) Olympus P_5 fiber endoscopy re-examination, see the distance from the tooth 28cm at the esophagus there is an area of ​​about 1.0 × 0.6cm ~ 2 ulcer lesions, surrounded by three erythema, this section to the cardia stenosis , About 1.2cm in diameter, the mucosal light soft, normal peristalsis, good expansion.Discussion: misdiagnosed as esophageal cancer in children have the following lessons: ① first hospital physicians in the history of the collection, analysis is not comprehensive enough, simply by Of the “vomiting after eating” to make a sloppy diagnosis is not appropriate enough; ② too much to believe X-ray examination, while ignoring the use of gastroscopy to consider this valuable tool; ③ ignore the age differential diagnosis: According to the literature Reported that esophageal cancer more common in men over the age of 40, especially in 60 to 70 years old