Fung Elaine W, Gan Kenton D, Lacson Atilano, Lees Gordon M, El-Hakim Hamdy
Department of Pediatrics, University of Alberta Hospital, Edmonton, Alberta, Canada.
Int J Pediatr Otorhinolaryngol. 2008 Oct;72(10):1563-8. doi: 10.1016/j.ijporl.2008.06.019. Epub 2008 Aug 20.
An esophageal mucocele causing airway obstruction is an exceptionally rare complication of esophageal diversion in children. In this instance, they are fluid-filled dilatations of the esophageal remnant following bipolar exclusion of the thoracic esophagus. Only six pediatric cases have been reported previously in the literature. We present two consecutive cases of esophageal mucoceles causing respiratory distress in children following surgical exclusion of the esophagus. Bronchoscopy followed by imaging (computerized tomography or magnetic resonance imaging) was used to reach the diagnosis. Complete resection of the thoracic esophagus was required in both patients. Esophageal mucoceles can occur many years after esophageal exclusion, and the clinical features are often non-specific. Furthermore, complex co-morbidities may mask the underlying etiology of the respiratory distress, thus the diagnosis may be difficult to delineate. A high degree of suspicion, clinical awareness, and the use of the proper diagnostic tools, are essential for a diagnosis of mucoceles in children with a past history of esophageal exclusion.
食管黏液囊肿导致气道梗阻是儿童食管转流术极为罕见的并发症。在此病例中，它们是胸段食管双极切除术后食管残端的液性扩张。此前文献仅报道过6例儿科病例。我们报告两例连续的儿童食管黏液囊肿病例，均在食管手术切除后出现呼吸窘迫。通过支气管镜检查并结合影像学检查（计算机断层扫描或磁共振成像）做出诊断。两名患者均需行胸段食管完全切除术。食管黏液囊肿可在食管切除术后数年发生，临床特征往往不具有特异性。此外，复杂的合并症可能掩盖呼吸窘迫的潜在病因，因此诊断可能难以明确。对于有食管切除术病史的儿童，高度怀疑、临床意识以及使用适当的诊断工具对于黏液囊肿的诊断至关重要。
