Min Jinsoo, Cho Young-Jae
Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Tuberc Respir Dis (Seoul). 2016 Apr;79(2):98-100. doi: 10.4046/trd.2016.79.2.98. Epub 2016 Mar 31.
We present a rare case of critically compromised airway secondary to a massively dilated sequestered colon conduit after several revision surgeries. A 71-year-old male patient had several operations after the diagnosis of gastric cancer. After initial treatment of pneumonia in the pulmonology department, he was transferred to the surgery department for feeding jejunostomy because of recurrent aspiration. However, he had respiratory failure requiring mechanical ventilation. The chest computed tomography (CT) scan showed pneumonic consolidation at both lower lungs and massive dilatation of the substernal interposed colon compressing the trachea. The dilated interposed colon was originated from the right colon, which was sequestered after the recent esophageal reconstruction with left colon interposition resulting blind pouch at both ends. It was treated with CT-guided pigtail catheter drainage via right supraclavicular route, which was left in place for 2 weeks, and then removed. The patient remained well clinically, and was discharged home.
我们报告了一例罕见病例，该患者在多次翻修手术后，因巨大扩张的隔离结肠导管导致气道严重受损。一名71岁男性患者在被诊断为胃癌后接受了多次手术。在呼吸内科初步治疗肺炎后，由于反复误吸，他被转到外科进行空肠造口喂养。然而，他出现了呼吸衰竭，需要机械通气。胸部计算机断层扫描（CT）显示双下肺肺炎实变，胸骨后插入结肠巨大扩张，压迫气管。扩张的插入结肠起源于右结肠，在最近一次用左结肠插入进行食管重建后被隔离，两端形成盲袋。通过右锁骨上途径进行CT引导下猪尾导管引流治疗，导管留置2周后拔除。患者临床情况良好，随后出院回家。
