Kahlberg Andrea, Marrocco-Trischitta Massimiliano M, Marone Enrico M, Amato Alexandre C M, Melissano Germano, Chiesa Roberto
Vascular Surgery, "Vita-Salute" University, Scientific Institute San Raffaele, Milan, Italy.
J Endovasc Ther. 2009 Apr;16(2):238-42. doi: 10.1583/08-2604.1.
To report an unusual case of dysphagia that developed immediately after stent-grafting of a thoracoabdominal aortic aneurysm.
A 79-year-old woman was submitted to a staged hybrid repair of a thoracoabdominal aortic aneurysm and developed new onset dysphagia and regurgitation early after stent-grafting of the thoracic aorta. Esophageal imaging showed a marked endoluminal stenosis, suggesting the development of secondary achalasia. The patient was submitted to endoscopic injections of botulinum toxin at the lower esophageal sphincter, which completely resolved the symptoms.
Acute dysphagic syndrome after thoracic aorta endografting has been anecdotically reported, and its etiology remains undefined. In this report, we illustrate the clinical features of this rare condition, discuss etiological hypotheses, and suggest a noninvasive therapeutic approach.
报告一例胸腹主动脉瘤支架植入术后立即出现吞咽困难的罕见病例。
一名79岁女性接受了胸腹主动脉瘤的分期杂交修复术，在胸主动脉支架植入术后早期出现了新发的吞咽困难和反流。食管成像显示明显的腔内狭窄，提示继发性贲门失弛缓症的发生。该患者接受了食管下括约肌肉毒杆菌毒素内镜注射，症状完全缓解。
胸主动脉腔内修复术后急性吞咽困难综合征已有零星报道，其病因尚不明确。在本报告中，我们阐述了这种罕见疾病的临床特征，讨论了病因假说，并提出了一种非侵入性治疗方法。
