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[三例食管自发性破裂(博赫哈夫综合征)]

[Three cases of spontaneous rupture of the oesophagus (Boerhaave's syndrome)].

作者信息

Yamaga T, Nakamura H, Sugiyama N, Yoshino Y, Morio S

机构信息

Department of Thoracic Surgery, Tottori prefectural Central Hospital.

出版信息

Kyobu Geka. 1990 Jun;43(6):462-6.

PMID:2385020
Abstract

We reported three cases of spontaneous rupture which were surgically treated with direct suture method. One patient was operated on within eight hours after rupture with good results. In two patients diagnoses were made more than two days after rupture. One had esophageal fistula, but completely recovered after cervical oesophageal fistula, and another died of multiple organ failure. In this syndrome, early diagnosis and surgical treatment are essential for acceptable results. For early diagnosis, we emphasized on the presence of roentgenologic mediastinal and cervical emphysema. In patients for whom diagnosis was delayed and post-operative leakage at the oesophageal suture line occurred, temporarily fistulation of the cervical oesophagus proved to be effective in exclusion and diversion of the ruptured segment.

摘要

我们报告了3例采用直接缝合术进行手术治疗的自发性破裂病例。1例患者在破裂后8小时内接受手术,效果良好。另外2例患者在破裂两天多后才确诊。其中1例发生食管瘘,但经颈段食管瘘修补后完全康复,另1例死于多器官功能衰竭。对于该综合征,早期诊断和手术治疗是取得可接受疗效的关键。为实现早期诊断,我们强调存在X线表现的纵隔和颈部气肿。对于诊断延误且食管缝合线处术后发生渗漏的患者,经证实,暂时行颈段食管造瘘对破裂段进行排除和转流是有效的。

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