Prokakis Christos, Charoulis Nikolaos, Tselikos Dimitrios, Koletsis Efstratios N, Apostolakis Efstratios, Dougenis Dimitrios
Department of Cardiothoracic Surgery, School of Medicine, University of Patras, 26500 Patras, Greece.
Tex Heart Inst J. 2009;36(6):607-10.
Aortoesophageal fistula is a rare emergency that presents a real challenge for cardiothoracic surgeons. There have been few reports of survivors. We present the case of a 70-year-old man with aortoesophageal fistula, mediastinal abscess, and severe septicemia consequent to esophageal erosion and rupture of a chronic degenerative descending thoracic aortic aneurysm. The patient underwent successful surgical treatment by aorto-aortic bypass and bipolar esophageal exclusion in conjunction with a cervical esophagostomy and a feeding gastrostomy. The pleural cavity was copiously irrigated and drained. Three months later, a retrosternal gastric bypass operation was performed successfully. The patient's 6-month follow-up examination revealed no problems.
主动脉食管瘘是一种罕见的急症，对心胸外科医生来说是一项真正的挑战。关于幸存者的报道很少。我们报告一例70岁男性患者，因慢性退行性降主动脉瘤的食管侵蚀和破裂导致主动脉食管瘘、纵隔脓肿和严重败血症。患者接受了主动脉-主动脉旁路移植和双极食管旷置术，并结合颈部食管造口术和胃造瘘术，手术成功。胸腔进行了大量冲洗和引流。三个月后，成功进行了胸骨后胃旁路手术。患者6个月的随访检查未发现问题。
