Kimura Masahiro, Kuwabara Yoshiyuki, Ishiguro Hideyuki, Tanaka Tatsuya, Takeyama Hiromitsu
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
Case Rep Surg. 2014;2014:926387. doi: 10.1155/2014/926387. Epub 2014 May 5.
We describe the management of a tracheoesophageal fistula due to a damaged tracheal stent, which was first inserted to treat tracheal stenosis. A 29-year-old woman with a history of treated epilepsy had a seizure and suffered from smoke inhalation during a fire. Breathing difficulties appeared and gradually worsened; consultation was obtained two years afterward. After undergoing a thorough examination, the patient was diagnosed with tracheal strangulation. A noncovered, metallic stent was inserted. When the patient was 37 years old, she was admitted to our hospital for the treatment of a tracheoesophageal fistula. We diagnosed it as a tracheoesophageal fistula due to the collapse of the damaged tracheal stent toward the esophageal side, and we decided to perform a mediastinal tracheostomy. Granulation may be formed in the circumference of a stent that has been present for a prolonged period, and removal of the stent may become difficult. This case suggests that insertion of a noncovered, metallic stent is contraindicated for a benign disease.
我们描述了一例因气管支架损坏导致的气管食管瘘的处理过程,该支架最初用于治疗气管狭窄。一名有癫痫治疗史的29岁女性在火灾中癫痫发作并吸入烟雾。出现呼吸困难并逐渐加重;两年后寻求会诊。经过全面检查,患者被诊断为气管受压。插入了一个无覆膜金属支架。患者37岁时因气管食管瘘入住我院。我们诊断其为气管食管瘘,原因是受损的气管支架向食管侧塌陷,我们决定进行纵隔气管造口术。长时间存在的支架周围可能会形成肉芽组织,取出支架可能会变得困难。该病例提示,无覆膜金属支架插入术不适用于良性疾病。