Zusammenfassung
Vorgestellt wird der Fall einer 75-jährigen Patientin mit Myasthenia gravis, die unter Medikation mit Pyridostigmin, Azathioprin und Prednisolon eine Candida-Ösophagitis und eine Ösophagusperforation mit abdomineller Fistelung entwickelte. Die Therapie erfolgte sonografisch-interventionell mit abdomineller und endoskopisch-interventionell mit mediastinaler Drainage. Unter Dauerspülung und antibiotischer sowie antimykotischer Therapie kam es zu einem Fistelverschluss innerhalb von 26 Tagen. Die Patientin wurde über eine PEG durchgehend enteral ernährt.
Abstract
This case report presents a 75-year-old woman suffering from myasthenia gravis who developed a Candida oesophagitis and oesophageal perforation with abdominal fistula under medication with pyridostigmin, azathioprine and prednisolone. Therapy was ultrasound-guided abdominal drainage and endoscopical mediastinal drainage. Under permanent lavage as well as antibiotic and antimycotic therapy the fistula healed within 26 days. The patient was fed via a percutaneous endoscopic gastrostomy all the time.
Schlüsselwörter
Ösophagusperforation - Myasthenia gravis - Candida-Ösophagitis - Azathioprin - Steroide - Pyridostigmin
Key words
oesophageal perforation - myasthenia gravis - candida oesophagitis - azathioprine - steroids - pyridostigmin
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Dr. Thomas Müller
Medizinische Klinik I, Klinikum am Steinenberg
Steinenbergstraße 31
72764 Reutlingen
eMail: mueller_tho@klin-rt.de
