Shinozuka Eriko, Nomura Tsutomu, Miyashita Masao, Makino Hiroshi, Okawa Keiichi, Hagiwara Nobutoshi, Shigehara Kengo, Akagi Ichiro, Shioda Yoshinobu, Uchida Eiji
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
J Nippon Med Sch. 2010 Dec;77(6):338-41. doi: 10.1272/jnms.77.338.
An 80-year-old woman was admitted to our hospital with severe chest and back pains after vomiting. Computed tomography (CT) of the chest revealed left-sided pneumothorax and pleural effusion. Some food was drained from an inserted chest tube, and we diagnosed spontaneous esophageal rupture (Boerhaave's syndrome). A left thoracotomy was performed 7 hours after the onset of symptoms. A 3-cm perforation was discovered in the lateral wall of the distal esophagus. The perforation was repaired with a primary two-layered closure and covered with pericardial fat. The patient had a good postoperative course and was discharged 1 month after surgery. This case suggests the importance of early surgical treatment, even in elderly patients with spontaneous esophageal rupture.
一名80岁女性在呕吐后因严重胸痛和背痛入院。胸部计算机断层扫描(CT)显示左侧气胸和胸腔积液。从插入的胸管中引出了一些食物,我们诊断为自发性食管破裂(Boerhaave综合征)。症状出现7小时后进行了左胸切开术。在食管远端侧壁发现一个3厘米的穿孔。穿孔采用一期双层缝合修复,并用心包脂肪覆盖。患者术后恢复良好,术后1个月出院。该病例表明,即使是老年自发性食管破裂患者,早期手术治疗也很重要。