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腹腔镜袖状胃切除术后的胃支气管瘘

Gastrobronchial fistula following laparoscopic sleeve gastrectomy.

作者信息

Abraham Albin, Virdi Ravi Paul Singh, Rajan Dhyan, Singh Jaspreet, Mustacchia Paul, Iqbal Javed, Rizvon Kaleem

机构信息

Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.

出版信息

BMJ Case Rep. 2012 Sep 12;2012:bcr2012006789. doi: 10.1136/bcr-2012-006789.

Abstract

Acquired fistulas between the tracheobronchial tree and the gastrointestinal tract are rare but serious complications of laparoscopic sleeve gastrectomies with significant morbidity and mortality. With the rising popularity and widespread acceptance of bariatric surgery techniques, the occurrence of gastrobronchial fistulas is being increasingly recognised. We present the case of a 26-year-old woman who underwent laparoscopic sleeve gastrectomy for morbid obesity and presented later with a history of chronic productive cough. Upper gastrointestinal series showed the presence of a communicating fistula between the stomach and the lung, with extravasation of contrast into the lung. The aim of this paper is to highlight the importance of considering the diagnosis of a gastrobronchial fistula in cases of persistent respiratory infections in the postoperative period following bariatric surgery and to review its incidence, clinical manifestations and treatment.

摘要

气管支气管树与胃肠道之间的后天性瘘管较为罕见,但却是腹腔镜袖状胃切除术严重的并发症,具有较高的发病率和死亡率。随着减肥手术技术越来越普及并被广泛接受,胃支气管瘘的发生越来越受到关注。我们报告一例26岁女性患者,因病态肥胖接受腹腔镜袖状胃切除术,术后出现慢性咳痰史。上消化道造影显示胃与肺之间存在交通瘘,造影剂渗入肺内。本文旨在强调在减肥手术后出现持续呼吸道感染的病例中考虑胃支气管瘘诊断的重要性,并综述其发病率、临床表现及治疗方法。

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