Catani Marco, De Milito Ritanna, Chiaretti Massimo, Capitano Sante, Battillocchi Barbara, Vermeil Viviana, Frattaroli Stefano, Toccaceli Stefano, Negro Paolo
Dipartimento di Chirurgia Generale, Specialità Chirurgiche e Trapianti d'Organo Paride Stefanini, Università degli Studi di Roma La Sapienza.
Chir Ital. 2003 Jan-Feb;55(1):113-8.
The Authors describe a rare case of esophageal perforation occurred after Transoesophageal echocardiography in 68 years old patient and review the literature relating to the causes and management of this pathology. Transoesophageal echocardiography, which is a semi-invasive investigation increasingly used in cardiology and cardiac surgery and intensive care units, is a rare though extremely dangerous cause of such complications. Perforation of the esophagus continues to present a formidable diagnostic and therapeutic challenge. The diagnosis depends on a high degree of suspicion and on the recognition of clinical features and is confirmed by contrast esophagography. The outcome after esophageal perforation depends on the location of the injury, the presence or otherwise of concomitant esophageal disease and the time elapsing between the injury and inititian of treatment. Reinforced primary repair of the perforation is the procedure most frequently employed and preferred for the surgical management of the esophageal perforation. In the case reported here, early diagnosis and prompt surgical treatment consisting in primary repair of the esophageal perforation contributed to the successful management of this serious pathology.
作者描述了一例68岁患者经食管超声心动图检查后发生食管穿孔的罕见病例，并回顾了有关该疾病病因及治疗的文献。经食管超声心动图是一种在心脏病学、心脏外科和重症监护病房中越来越常用的半侵入性检查，虽然是此类并发症的罕见病因，但极其危险。食管穿孔仍然是一个巨大的诊断和治疗挑战。诊断依赖于高度的怀疑以及对临床特征的识别，并通过食管造影加以证实。食管穿孔后的预后取决于损伤的部位、是否存在合并的食管疾病以及损伤与治疗开始之间所经过的时间。加强穿孔的一期修复是食管穿孔外科治疗中最常采用且首选的手术方式。在本文报道的病例中，早期诊断及迅速采取的食管穿孔一期修复手术治疗促成了对这一严重疾病的成功处理。
