Esophageal mucosal damage

Our esophagus is a very important organ for us, but many people will have some esophageal damage during the meal. Because most people's esophageal damage will easily cause esophageal mucosa inflammation, then you will feel chest pain, severe patients may also have a fever, so what should we do when the esophageal mucosa is damaged?

Esophageal mucosal injury is one of the common esophageal traumas, and most cases are neglected because the injury is not serious. Clinically, it can heal itself and infection is less likely to occur. Esophageal mucosal injury and infection may form submucosal abscesses. Mucosal injury can also manifest as submucosal hematoma, which causes the surface layer and the propria of the esophageal mucosa to be completely peeled off, forming a tubular shape and spitting out from the mouth, shaped like a ribbon hanging at the corners of the mouth and connected to the pharynx. It is called "esophageal mucosal tubular exfoliation" and is also called "superficial exfoliative esophagitis" and "traumatic exfoliative esophagitis." Most patients of this type first feel chest tightness, blockage or pain shortly after eating, and then vomit, spitting out large amounts of bright red blood. At the same time, white tubular membrane-like objects are vomited out, connected to the floor of the mouth, of varying lengths, and causing severe pain when pulled.

When the mucosal damage is mild, the symptoms are mild or even no obvious symptoms. Minor injuries often manifest as pain and burning sensation behind the sternum when swallowing food, which is aggravated by eating spicy, hot, and dry foods. The pain may radiate to the left side of the back below the shoulder blade. If there is no serious infection, the above symptoms will disappear after 3 to 5 days. However, a small number of patients will develop complications of infection and form submucosal abscesses, which will cause high fever and severe pain behind the sternum, and they may even be unable to eat. The symptoms will not be alleviated or disappear until the abscess ruptures and pus is drained. Mucosal injury and infection may form submucosal abscesses.

Mucosal injury can also manifest as submucosal hematoma, which causes the surface layer and the propria of the esophageal mucosa to be completely peeled off, forming a tubular shape and spitting out from the mouth, shaped like a ribbon hanging at the corners of the mouth and connected to the pharynx. It is called "esophageal mucosal tubular exfoliation" and is also called "superficial exfoliative esophagitis" and "traumatic exfoliative esophagitis." The mechanism of its occurrence may be that after the esophageal mucosa is damaged, the blood vessels between the mucosal layer and the lamina propria are broken, and hematoma occurs. Due to the continuous increase and expansion of blood accumulation, the esophageal mucosa is exfoliated in a tubular shape. At this time, due to the effect of gravity, the blood falls, and the lower end of the esophagus bears a greater force. If it is slightly stimulated, such as vomiting, the mucosa will rupture. If the patient vomits, the exfoliated mucosal cast will turn over and come out of the mouth. The exfoliated tubular object is composed of squamous epithelium, without inflammation and necrosis. Most patients of this type first feel chest tightness, blockage or pain shortly after eating, and then vomit, spitting out large amounts of bright red blood. At the same time, white tubular membrane-like objects are vomited out, connected to the floor of the mouth, of varying lengths, and causing severe pain when pulled. Uppals et al. recently reported a case of esophageal obstruction caused by a meat ball. The patient had esophageal mucosal laceration due to forceful vomiting and a band of esophageal mucosa appeared in the mouth. The patient had no other complications and recovered uneventfully after conservative treatment. Many people also attribute this type of esophageal mucosal injury to the Mallory-Weiss sign.