Saikia Manuj Kumar, Kalita Jyoti Prasad, Handique Akash, Topno Noor, Sarma Kalyan
Professor and Head, Department of Cardiothoracic and Vascular Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences , Shillong, Meghalaya, India .
Assistant Professor, Department of Cardiothoracic and Vascular Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences , Shillong, Meghalaya, India .
J Clin Diagn Res. 2016 Aug;10(8):PD03-4. doi: 10.7860/JCDR/2016/15789.8303. Epub 2016 Aug 1.
The incidence of bronchoesophageal fistula in presence of benign pathology of tracheal tree or oesophagus is rare. It is encountered in thoracic diseases like tuberculosis, syphilis or histoplasmosis due to erosion by infected lymph node or abscess to adjoining structures. The source of primary pathology has to be eliminated followed by appropriate steps of fistula tract closure is essential for optimal result. We report a 25-year-old patient with left sided bronchoesophageal fistula. He had a past history of pulmonary tuberculosis. A left lower lobectomy followed by repair of oesophageal fistula opening was performed by primary closure and reinforcement with an intercostal muscle flap based on posterior intercostal artery. Postoperative oesophagogram showed short diverticula, which was occluded with n-butyl cyanoacrylate (NBCA) glue under radiological guidance. Feeding was started one week after application of glue without further complication. Reports on intercostals muscle flap repair and intervention of residual oesophageal diverticula with n-butyl cyanoacrylate (NBCA) glue under radiological guidance are scanty.
气管树或食管良性病变情况下支气管食管瘘的发生率很低。在结核病、梅毒或组织胞浆菌病等胸部疾病中，由于受感染的淋巴结或脓肿侵蚀至相邻结构而出现这种情况。必须消除原发病理来源，随后采取适当步骤闭合瘘管，这对于取得最佳效果至关重要。我们报告一名25岁左侧支气管食管瘘患者。他有肺结核病史。行左下肺叶切除术，随后通过一期缝合并用基于后肋间动脉的肋间肌瓣加固来修复食管瘘口。术后食管造影显示有短憩室，在放射学引导下用氰基丙烯酸正丁酯（NBCA）胶将其封堵。在使用胶水一周后开始进食，未出现进一步并发症。关于肋间肌瓣修复以及在放射学引导下用氰基丙烯酸正丁酯（NBCA）胶干预残余食管憩室的报道很少。
