Abstract
We report a case of a 32-year-old man with HIV infection who has an esophageal perforation of an idiopathic ulcer. He had been treated by conservative therapy, and an endoscopic therapy was performed for the closure of the perforation. The HIV infection was well controlled by anti-HIV drugs administration and the ulcer became scared.
In January 2002, he felt difficulty to swallow and had a high fever. He was admitted and computed tomography (CT) of the chest showed right pyothorax. Drainage of the pyothorax cavity and antibacterial therapy was performed. His blood examination indicated HIV infection.
Esophagogram showed an esophageal perforation. Endoscopic examination showed giant ulcer that was considered as idiopathic one because cytomegalovirus antigen was not detected in his blood and it was cured without anti-herpes-virus drugs. He was conducted enteral nutrition and medication of anti-HIV drugs through gastoric tube. HIV infection was well controlled and the ulcer got healed progressively, but the perforation remained. So we performed an endoscopic therapy which was a brushing technique with irregular epithelium on inner face of perforation cavity by a pancreatic duct biopsy brush. Successfully the perforation was closed and he could regain to take orally soon. He discharged 152 days after admission and his HIV-infection is controlled as an outpatient.
