Kimura Toru, Takemoto Toshiki, Fujiwara Yoshinori, Yane Katsunari, Shiono Hiroyuki
Department of General Thoracic Surgery, Nara Hospital, Kinki University School of Medicine, Ikoma, Nara, Japan.
Ann Thorac Cardiovasc Surg. 2013;19(4):289-92. doi: 10.5761/atcs.cr.12.01906. Epub 2012 Nov 15.
We herein report a case of thoracic esophageal perforation caused by a fish bone. The patient was a 68-year-old female who presented with a persistent sore throat after eating sea bream four days previously. She was diagnosed with an esophageal perforation and posterior mediastinal abscess formation by chest computed tomography and inflammatory findings in her blood test. Surgically indwelling drainage was able to effectively control the leakage of contaminants and infection. Endoscopic injection of fibrin glue into the long-standing thoracic-esophageal fistula promoted closure of the esophageal wall defect and enabled her to restart oral intake. This case report suggests that effective drainage and the use of fibrin glue sealant may be one of the treatment options for esophageal perforation.
我们在此报告一例由鱼骨导致的胸段食管穿孔病例。患者为一名68岁女性，四天前食用海鲷后出现持续咽痛。胸部计算机断层扫描及血液检查中的炎症表现显示她被诊断为食管穿孔并伴有后纵隔脓肿形成。手术留置引流能够有效控制污染物渗漏及感染。通过内镜向长期存在的胸段食管瘘内注射纤维蛋白胶促进了食管壁缺损的闭合，并使她能够重新开始经口进食。本病例报告提示，有效的引流及使用纤维蛋白胶密封剂可能是食管穿孔的治疗选择之一。
