Baker Cara R, Gossage James A, Mason Robert C
Department of General Surgery, St Thomas Hospital, London, UK.
Department of General Surgery, St Thomas Hospital, London, UK
J Surg Case Rep. 2013 Mar 15;2013(3):rjs042. doi: 10.1093/jscr/rjs042.
We present a 52-year-old gentleman with an unusual cause of progressive dysphagia, namely due to extrinsic lower oesophageal compression from a cystic mass of the posterior mediastinum. Cystic masses in adults are uncommon, and there is a wide differential diagnosis. This includes neoplastic, such as germ cell tumour (cystic teratoma), and non-neoplastic aetiologies. The later include foregut duplication cysts, lymphatic malformations, infective (hydatid), simple mediastinal cysts or pseudocysts. Management is principally surgical with complete excision, or alternatively, in cases of benign cysts, marsupialization or decompression. In our patient, a simple mediastinal cyst was diagnosed and this case is the first description of a totally transabdominal approach to mediastinal cyst decompression by a Roux-en-Y cyst-jejunostomy.
我们报告一名52岁男性，其进行性吞咽困难的病因不同寻常，是由于后纵隔的囊性肿物对食管下段造成外部压迫所致。成人的囊性肿物并不常见，鉴别诊断范围广泛。这包括肿瘤性病因，如生殖细胞肿瘤（囊性畸胎瘤），以及非肿瘤性病因。后者包括前肠重复囊肿、淋巴管畸形、感染性（包虫）、单纯纵隔囊肿或假性囊肿。治疗主要是手术切除，或者在良性囊肿的情况下，行袋形缝合术或减压术。在我们的患者中，诊断为单纯纵隔囊肿，且本病例是首例通过Roux-en-Y囊肿空肠吻合术经腹完全入路进行纵隔囊肿减压的描述。
