Nigri Giuseppe, Pezzoli Francesca, Giaccaglia Valentina, Di Giulio Emilio, D'Angelo Francesco, Aurello Paolo, Ramacciato Giovanni
Divisione di Chirurgia Generale, Università di Roma La Sapienza, II Facoltà di Medicina e Chirurgia, Policlinico Sant'Andrea , Roma.
Ann Ital Chir. 2008 May-Jun;79(3):205-7.
To discuss the diagnostic and therapeutic aspects of spontaneous esophageal perforation. It is considered a surgical emergency with high rate of mortality. Its diagnosis can be difficult since the presentation is often nonspecific and can be confused with others disorders. Many strategies have been advocated for its management. Prompt diagnosis and early treatment are required to decrease the poor prognosis of this condition. A conservative therapy may be effective in selected cases.
We described a successful non-surgical closure of a spontaneous esophageal perforation using an endoscopic stent, in an severely ill old patient. Although the treatment was delayed because of a late diagnosis, the patient survived the usually fatal condition.
The key to improve the prognosis of this life-threatening emergency is the immediate and correct diagnosis and the most appropriate selection of the primary employed procedure.
探讨自发性食管穿孔的诊断与治疗方面。它被视为一种具有高死亡率的外科急症。其诊断可能困难,因为临床表现往往不具特异性,且可能与其他疾病相混淆。针对其治疗已提出许多策略。需要及时诊断和早期治疗以降低该病症的不良预后。在某些特定病例中,保守治疗可能有效。
我们描述了在一名重症老年患者中,使用内镜支架成功非手术闭合自发性食管穿孔的案例。尽管由于诊断延迟导致治疗延误,但患者从通常致命的病情中存活下来。
改善这种危及生命急症预后的关键在于立即且正确的诊断以及对首要采用治疗方法的最恰当选择。