Katsetos Manny C, Tagbo Austin C, Lindberg Michael P, Rosson Robert S
Internal Medicine Residency Program, and Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT 06102-5037, USA.
South Med J. 2003 May;96(5):516-20. doi: 10.1097/01.SMJ.0000047744.34423.0B.
Esophageal perforation is a serious condition with a high mortality rate. Successful therapy depends on the size of the rupture, the time elapsed between rupture and diagnosis, and the underlying health of the patient. Common causes of esophageal perforation include medical instrumentation, foreign-body ingestion, and trauma. A case of esophageal perforation due to fish bone ingestion in a 70-year-old diabetic male is described here, with a review of the pertinent literature. The patient presented with odynophagia after a meal that included fish. Initial evaluation was nondiagnostic and the patient was discharged home. The patient returned 12 days later with fever, generalized weakness, and persistent dysphagia. Esophageal biopsy of a necrotic ulcer revealed foreign material with acute inflammatory changes. Computed tomography scan demonstrated a pneumomediastinum. The patient became hemodynamically unstable and died on the third hospital day.
食管穿孔是一种严重疾病，死亡率很高。成功的治疗取决于破裂口的大小、破裂与诊断之间的时间间隔以及患者的基础健康状况。食管穿孔的常见原因包括医疗操作、异物吞食和外伤。本文描述了一名70岁糖尿病男性因吞食鱼骨导致食管穿孔的病例，并对相关文献进行了综述。该患者在进食含鱼食物后出现吞咽疼痛。初步评估未明确诊断，患者出院回家。12天后，患者因发热、全身无力和持续吞咽困难再次就诊。坏死性溃疡的食管活检显示有异物伴急性炎症改变。计算机断层扫描显示纵隔气肿。患者血流动力学不稳定，于住院第三天死亡。
