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胃管致消化性溃疡并脑空气栓塞 1 例报告

Cerebral air embolism as a complication of peptic ulcer in the gastric tube: case report.

机构信息

Department of Gastroenterology, Nagoya University Graduate School of Medicine, (65 Tsurumai-cho, Showa-ku), Nagoya City, Aichi, (466-8550), Japan.

出版信息

BMC Gastroenterol. 2011 Dec 21;11:139. doi: 10.1186/1471-230X-11-139.

DOI:10.1186/1471-230X-11-139
PMID:22189053
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3258223/
Abstract

BACKGROUND

The reported incidence of ulcer formation in the gastric tube in esophageal replacement is rare.

CASE PRESENTATION

This is the first report of a case of cerebral air embolism as a result of spontaneous perforation of an ulcer in the constructed gastric tube into the pulmonary vein during post-operative follow-up in a patient with esophageal cancer.

CONCLUSIONS

Cerebral air embolism is a rare complication of penetrating gastric ulcer, but should be considered in patients with a history of esophagectomy with gastric conduit that present with acute neurologic findings.

摘要

背景

在食管替代中,胃管形成溃疡的报道发生率较低。

病例报告

这是首例报告一例因构建的胃管中的溃疡自发性穿孔进入肺静脉而导致的脑空气栓塞的病例,该病例发生在食管癌术后随访期间。

结论

穿透性胃溃疡导致脑空气栓塞是一种罕见的并发症,但对于有胃管食管切除术病史且出现急性神经症状的患者,应考虑这种并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a20/3258223/c2e57df113e2/1471-230X-11-139-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a20/3258223/de3af6a80cd5/1471-230X-11-139-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a20/3258223/c2e57df113e2/1471-230X-11-139-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a20/3258223/de3af6a80cd5/1471-230X-11-139-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a20/3258223/c2e57df113e2/1471-230X-11-139-2.jpg

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本文引用的文献

1
Cerebral gas embolism due to upper gastrointestinal endoscopy.因上消化道内镜检查导致的脑气体栓塞。
Eur J Gastroenterol Hepatol. 2009 Jul;21(7):833-5. doi: 10.1097/MEG.0b013e328310aefc.
2
Peptic ulcer of the gastric tube after esophagectomy for cancer: clinical implications.食管癌切除术后胃管的消化性溃疡:临床意义
Dis Esophagus. 2007;20(6):542-5. doi: 10.1111/j.1442-2050.2007.00706.x.
3
Peptic ulcer-induced acute aortogastric fistula occurring 7 years after a pharyngogastrostomy following a resection for carcinoma of the esophagus: report of a case.
食管癌切除术后行咽胃吻合术7年后发生消化性溃疡所致急性主动脉胃瘘:病例报告
Surg Today. 2004;34(9):777-9. doi: 10.1007/s00595-004-2826-1.
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Purulent pneumopericarditis due to ulcer of the retrosternal stomach roll after esophagectomy.食管切除术后胸骨后胃襻溃疡所致脓性心包积气
Eur J Cardiothorac Surg. 2002 Dec;22(6):1007. doi: 10.1016/s1010-7940(02)00564-x.
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Ulcer in the gastric tube for esophageal replacement: a comparison of 12 esophageal cancer patients with or without postoperative radiotherapy.用于食管替代的胃管溃疡:12例接受或未接受术后放疗的食管癌患者的比较
J Gastroenterol Hepatol. 2001 Feb;16(2):137-41. doi: 10.1046/j.1440-1746.2001.02415.x.
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Fatal non-malignant ulceration in the gastric tube after oesophagectomy.食管癌切除术后胃管出现致命性非恶性溃疡。
J Clin Pathol. 1993 May;46(5):483-5. doi: 10.1136/jcp.46.5.483.
7
Increased chemiluminescence and ulcer development in the low blood flow state of the gastric tube for esophageal replacement.用于食管替代的胃管低血流状态下化学发光增加及溃疡形成。
J Clin Gastroenterol. 1993;17 Suppl 1:S161-6. doi: 10.1097/00004836-199312001-00028.
8
Late benign intrathoracic gastric perforation after oesophagectomy for carcinoma.食管癌切除术后晚期良性胸内胃穿孔
Br Med J (Clin Res Ed). 1981 May 9;282(6275):1512-3. doi: 10.1136/bmj.282.6275.1512-a.
9
Occurrence of peptic ulcer in the gastric tube used for esophageal replacement in adults.成人食管置换术中所使用胃管发生消化性溃疡的情况。
Jpn J Surg. 1987 May;17(3):190-4. doi: 10.1007/BF02470598.
10
Gastropericardial and gastrobrachiocephalic vein fistulae caused by penetrating ulcers in a gastric pedicle following esophageal cancer resection: a case report.食管癌切除术后胃蒂穿透性溃疡导致的胃心包和胃臂头静脉瘘:一例报告
Jpn J Surg. 1991 Jan;21(1):96-9. doi: 10.1007/BF02470872.