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经血管腔内治疗挽救合并食管瘘的感染性胸主动脉瘤局限性破裂

Endovascular salvage for contained rupture of infected thoracic aortic aneurysm with esophageal fistula.

作者信息

Kuo Ling-Wei, Lin Chia-Hsun

机构信息

School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.

Division of Cardiovascular Surgery, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

出版信息

Ann Vasc Surg. 2014 Apr;28(3):742.e13-5. doi: 10.1016/j.avsg.2013.08.006. Epub 2013 Oct 27.

Abstract

Aortoesophageal fistula is a rare but lethal condition. The initial presentations of the disease are mostly nonspecific, such as midthoracic pain, dysphagia, or episodes of gastrointestinal bleeding. Therefore, diagnosis is often delayed. Furthermore, despite timely diagnosis and management, the outcome is generally reported to be disappointing. Surgical intervention is the only chance for patient survival, but the optimal operative approach remains controversial. We present a case of esophageal perforation resulting from the contained rupture of an infected thoracic aortic aneurysm that was successfully managed by thoracic endovascular aneurysm repair and subsequent esophagectomy and reconstruction. The patient was 4 years after surgery.

摘要

主动脉食管瘘是一种罕见但致命的疾病。该疾病的初始表现大多是非特异性的,如胸中部疼痛、吞咽困难或胃肠道出血发作。因此,诊断往往延迟。此外,尽管进行了及时的诊断和治疗,但总体报道的结果仍令人失望。手术干预是患者生存的唯一机会,但最佳手术方法仍存在争议。我们报告一例因感染性胸主动脉瘤局限性破裂导致食管穿孔的病例,该病例通过胸主动脉腔内修复术以及随后的食管切除术和重建术成功治疗。患者术后已4年。

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