Antonacci Nicola, Sciannamea Gianluca, Antonacci Filippo, Casadei Riccardo, Ricci Claudio, Di Saverio Salomone, Minni Francesco
Department of General Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
BMJ Case Rep. 2010 Nov 5;2010:bcr0420102950. doi: 10.1136/bcr.04.2010.2950.
The case of a 58-year-old man with a large midthoracic oesophageal diverticulum and a left diaphragmatic relaxation who presented with night regurgitations, abdominal bloating, epigastric burning and a sensation of fullness after meals is reported. The patient underwent a successful thoracotomic diverticulectomy with left diaphragmatic plicature. The postoperative course was uneventful. To our knowledge this is the first reported case of an association between midthoracic oesophageal diverticulum and left diaphragmatic relaxation. Moreover, we hypothesised that the diverticulum was caused by a pulsion mechanism due to obstruction of the distal oesophagus secondary to diaphragmatic relaxation.
报告了一例58岁男性患者,患有巨大的胸中段食管憩室和左侧膈肌松弛,表现为夜间反流、腹胀、上腹部烧灼感和饭后饱胀感。患者接受了成功的开胸憩室切除术并进行了左侧膈肌折叠术。术后过程顺利。据我们所知,这是首次报道胸中段食管憩室与左侧膈肌松弛相关的病例。此外,我们推测该憩室是由于膈肌松弛继发远端食管梗阻导致的一种冲动机制引起的。