Department of Surgery, St. James's Hospital and Trinity Center for Health Sciences, Dublin, Ireland.
Department of Surgery, St. James's Hospital and Trinity Center for Health Sciences, Dublin, Ireland.
Ann Thorac Surg. 2013 Oct;96(4):1456-1457. doi: 10.1016/j.athoracsur.2013.01.091.
Esophageal perforation in achalasia is rare. The risk would mainly follow pneumatic dilatation, and spontaneous perforation has not been described. We report a case of spontaneous rupture of the midesophagus in a 56-year-old woman with treated achalasia in whom the perforation occurred during a meal and was not preceded by emesis. A gastrografin swallow confirmed extravasation of contrast medium from the esophagus, and endoscopy revealed significant esophageal food stasis, consistent with achalasia, with a large tear in the midesophagus and gross mediastinal contamination. She subsequently underwent a three-stage esophagectomy with an uneventful recovery.
贲门失弛缓症并发食管穿孔罕见，主要发生于行气囊扩张治疗后，自发性穿孔尚未见报道。我们报告 1 例 56 岁女性贲门失弛缓症患者，其在进餐时发生食管中段自发性破裂，破裂前无呕吐。上消化道造影证实造影剂外渗，内镜检查显示食管内大量食物潴留，符合贲门失弛缓症，食管中段有大的撕裂口，纵隔严重污染。随后患者接受了分期食管切除术，恢复顺利。
