Theegarten D, Klodt M, Konietzko N, Hartung W
Abteilung für Pathologie, Ruhr-Universität Bochum.
Pneumologie. 1992 May;46(5):203-5.
A woman patient admitted for treatment, who had reached the age of 65 years, had a previous history of an open pulmonary tuberculosis in 1946 that had been treated at that time by means of collapsotherapy and phrenico-exeresis. Pleuropneumonectomy was performed in 1976 because of a residual cavity of a thoracic empyema. Since 1978 the patient suffered from a fistula of the bronchus treated by postural therapy without achieving a cure. In 1989 a fistula formed between oesophagus and pneumonectomy cavity. Clinically this was associated with an increasing reduction of performance and a suddenly ineffective postural drainage, resulting in triphasic and eventually fatal aspiration. Histology revealed a suppurative inflammation in the fistular channel and a slight superficial Candida colonisation of the pneumonectomy cavity, of the fistular channel and of adjacent mucous glands of the oesophagus. Formation of the fistula was probably due to a small traction diverticulum followed by perforation because of obstructed oesophageal passage due to scarified distortions.
一名65岁的女性患者因接受治疗入院。她曾在1946年患开放性肺结核，当时采用萎陷疗法和膈神经切除术进行治疗。1976年因胸廓脓胸残留空洞行胸膜肺切除术。自1978年以来，患者患有支气管瘘，采用体位疗法治疗但未治愈。1989年，食管与肺切除腔之间形成瘘管。临床上，这与身体机能逐渐下降以及体位引流突然无效有关，导致三相性并最终致命的误吸。组织学检查显示瘘管通道有化脓性炎症，肺切除腔、瘘管通道及食管相邻黏液腺有轻度浅表念珠菌定植。瘘管形成可能是由于一个小的牵引憩室，随后因瘢痕变形导致食管通道阻塞而穿孔。
