Witzel Kai, Riester Ursula, Arps Hartmut, Kronsbein Hartmut, Benhidjeb Tahar
Chirurgische Universitätsklinik, PMU Salzburg, Austria.
Wien Klin Wochenschr. 2008;120(3-4):118-20. doi: 10.1007/s00508-007-0836-x.
Mastitis originating from a fistula from intramediastinal esophago-jejunostomy following gastrectomy is an extremely rare event. We report on a 79-year old woman who had undergone repeated surgery due to recurrent breast abscesses for more than a year. The patient's history showed gastrectomy and esophago-jejunostomy two years earlier, with subsequent undetected insufficiency of the anastomosis and inflammation of the breast. The reason for the recurrent breast abscesses was found intraoperatively to be due to a fistula which could be followed to the anastomosis. Histologically, vegetable tissue (food particles) was detected in the fistula specimen. Detailed assessment of the patient's history could have helped detecting the circumstances when the first breast abscess appeared. Exact preoperative diagnosis and accurate wound débridement could have revealed the real cause of the recurrent abscess formation much earlier.
胃切除术后纵隔内食管空肠吻合口瘘引发的乳腺炎是极为罕见的情况。我们报告一位79岁女性,她因反复出现乳房脓肿接受了一年多的多次手术。患者病史显示两年前曾行胃切除术和食管空肠吻合术,随后出现未被发现的吻合口瘘和乳房炎症。术中发现反复乳房脓肿的原因是存在可追溯至吻合口的瘘管。组织学检查发现瘘管标本中有植物组织(食物颗粒)。对患者病史进行详细评估本可有助于发现首次乳房脓肿出现时的情况。准确的术前诊断和精确的伤口清创本可更早揭示反复脓肿形成的真正原因。