Sato S, Kajiyama Y, Kuniyasu T, Machida M, Ouchi K, Sakai N, Sakamoto S, Iwanuma Y, Kamano T, Okamura S, Nagahama A, Tsurumaru M
First Department of Surgery, Juntendo University School of Medicine, Ouji Hospital, Tokyo, Japan.
Dis Esophagus. 2002;15(3):250-2. doi: 10.1046/j.1442-2050.2002.00253.x.
Perforations of the esophagus are uncommon complications of flexible gastrointestinal endoscopy. Perforations after endoscopy are likely to occur in the cervical esophagus, where fiber insertion is difficult anatomically. The diagnosis should be made as soon as possible, because mediastinitis and sepsis frequently develop following esophageal perforations. The surgical strategies are dependent on the location of the perforations and the condition of the patients. For a successful outcome, surgery is a preferred treatment for most perforation cases, and non-operative treatment, such as antibiotics, parental nutrition, and no food intake by mouth, should be applied carefully.
食管穿孔是柔性胃肠内镜检查罕见的并发症。内镜检查后的穿孔很可能发生在颈段食管，该部位在解剖学上纤维插入困难。应尽快做出诊断，因为食管穿孔后纵隔炎和脓毒症经常发生。手术策略取决于穿孔的部位和患者的状况。为了获得成功的结果，手术是大多数穿孔病例的首选治疗方法，应谨慎应用非手术治疗，如抗生素、肠外营养和禁食。
