Mok Vivian W K, Ting Albert C W, Law Simon, Wong Kam Ho, Cheng Stephen W K, Wong John
Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, China.
J Vasc Surg. 2004 Dec;40(6):1234-7. doi: 10.1016/j.jvs.2004.08.044.
A 67-year-old man with previous total gastrectomy and roux-en-Y esophagojejunostomy had hematemesis 4 weeks after esophagectomy performed because of carcinoma of the esophagus. Investigation showed an aortojejunal fistula with a thoracic aortic pseudoaneurysm. Endovascular stent grafting of the pseudoaneurysm, followed by endoscopic injection of fibrin sealant for the fistula, was performed, and the infection was controlled with broad-spectrum antibiotic agents together with drainage and daily irrigation of the pseudoaneurysm sac. The fistula subsequently healed. The patient remained well 14 months after the procedure; follow-up computed tomograms at 12 months did not show any pseudoaneurysm, and there was no evidence of reopening of the fistula.
一名67岁男性，既往行全胃切除术及Roux-en-Y食管空肠吻合术，因食管癌行食管切除术后4周出现呕血。检查发现主动脉空肠瘘合并胸主动脉假性动脉瘤。对假性动脉瘤进行血管内支架植入，随后通过内镜注射纤维蛋白密封剂封堵瘘口，并使用广谱抗生素控制感染，同时对假性动脉瘤囊进行引流和每日冲洗。瘘口随后愈合。术后14个月患者情况良好；12个月时的随访计算机断层扫描未显示任何假性动脉瘤，也没有瘘口重新开放的迹象。
