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使用套扎器系统治疗创伤性食管胸膜瘘

Treatment of Traumatic Esophagopleural Fistula Using the Over-the-Scope-Clip System.

作者信息

Kim Ji Hyoung, Park Jong-Jae, Jung Il Woo, Kim Sang Hoon, Kim Hee Dong, Choe Jung Wan, Joo Moon Kyung, Kim Hyun Gu

机构信息

Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Department of Cardiothoracic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

出版信息

Clin Endosc. 2015 Sep;48(5):440-3. doi: 10.5946/ce.2015.48.5.440. Epub 2015 Sep 30.

Abstract

Esophagopleural fistula (EPF) is a rare condition that is usually accompanied by severe infection and life-threatening morbidity. Here, we report the successful treatment of an EPF by closing an esophageal orifice using the over-the-scope-clip (OTSC) system without postprocedural complications. A 41-year-old man had serious thoracic and abdominal trauma due to a traffic accident. Computed tomography revealed findings suggestive of esophageal rupture due to Boerhaave syndrome. An emergent explorative operation was performed for primary repair with the insertion of a vacuum-assisted closure device. A postoperative upper gastrointestinal series revealed an EPF tract connecting the left pleural space and distal esophagus. We performed an endoscopic procedure using the "traumatic-type"OTSC to seal the EPF, and the esophageal orifice was completely healed 2 weeks postoperatively. The OTSC system might represent a safe and feasible modality for the treatment of EPF.

摘要

食管胸膜瘘(EPF)是一种罕见的病症,通常伴有严重感染和危及生命的发病率。在此,我们报告了一例通过使用内镜下圈套夹(OTSC)系统封闭食管口成功治疗EPF且无术后并发症的病例。一名41岁男性因交通事故导致严重的胸腹部创伤。计算机断层扫描显示有提示因Boerhaave综合征导致食管破裂的表现。进行了急诊探查手术以进行一期修复并插入负压封闭引流装置。术后上消化道造影显示一条连接左胸腔和食管远端的EPF通道。我们使用“创伤型”OTSC进行了内镜手术以封闭EPF,术后2周食管口完全愈合。OTSC系统可能是治疗EPF的一种安全可行的方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a870/4604285/d35945139d3b/ce-48-440-g001.jpg

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