Division of Hepatogastroenterology, Chang Gang Memorial Hospital, Niaosung Hsiang, Kaohsiung Country 833, Taiwan, China.
World J Gastroenterol. 2009 Sep 21;15(35):4461-3. doi: 10.3748/wjg.15.4461.
Pneumatic dilation (PD) is considered to be a safe and effective first line therapy for achalasia. The major adverse event caused by PD is esophageal perforation but an immediate gastrografin test may not always detect a perforation. It has been reported that delayed management of perforation for more than 24 h is associated with high mortality. Surgery is the treatment of choice within 24 h, but the management of delayed perforation remains controversial. Hereby, we report a delayed presentation of intrathoracic esophageal perforation following PD in a 48-year-old woman who suffered from achalasia. She completely recovered after intensive medical care. A review of the literature is also discussed.
气动扩张术(PD)被认为是治疗贲门失弛缓症的一种安全有效的一线治疗方法。PD 引起的主要不良事件是食管穿孔,但即时胃造影检查并不总能检测到穿孔。据报道,穿孔后超过 24 小时的延迟处理与高死亡率相关。穿孔后 24 小时内手术是首选治疗方法,但延迟性穿孔的处理仍存在争议。在此,我们报告了一例 48 岁女性在 PD 后出现的迟发性胸腔内食管穿孔,该患者患有贲门失弛缓症。经强化医疗护理后,她完全康复。同时也对文献进行了回顾。