Miura Akinori, Nishigori Tatsuto, Izumi Yousuke, Katou Tsuyoshi, Ryoutokuji Tairo, Momma Kumiko
Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2011 Mar;108(3):436-43.
A 77-year-old man was admitted to our hospital on a diagnosis of acute mediastinits, 17 days after he had high fever. Computed tomography of the chest revealed an abscess cavity in the left upper mediastinum. Endoscopic examination showed multiple pin-hole perforations in the upper esophagus from 23 to 24cm distal from the incisors and drainage through the perforation. We diagnosed acute mediastinitis caused by multiple esophageal perforations of unknown etiology. We initiated conservative therapy. Oral intake was restarted on the 17th day because radiological examination showed the esophageal perforation had closed. The patient was discharged on the 36th day from admission. Although mediastinitis caused by esophageal perforation often demands surgical treatment, conservative nonoperative therapy was successful in this patient.
一名77岁男性在高热17天后因急性纵隔炎入住我院。胸部计算机断层扫描显示左上纵隔有一个脓肿腔。内镜检查显示，在距门齿23至24厘米处的上段食管有多个针孔样穿孔，并通过穿孔进行引流。我们诊断为由不明病因的多处食管穿孔引起的急性纵隔炎。我们开始进行保守治疗。由于影像学检查显示食管穿孔已闭合，于第17天重新开始经口进食。患者入院第36天出院。虽然食管穿孔引起的纵隔炎通常需要手术治疗，但该患者保守非手术治疗成功。
