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围手术期经食管超声心动图检查后食管穿孔:一例报告

Esophageal perforation after perioperative transesophageal echocardiography: a case report.

作者信息

Kim Hyun-Chang, Oh Jung-Hyou, Lee Yong-Cheol

机构信息

Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine, 56, Dalseong-ro, Jung-gu, Daegu, 41931, Korea.

出版信息

J Med Case Rep. 2016 Dec 1;10(1):338. doi: 10.1186/s13256-016-1131-0.

Abstract

BACKGROUND

Transesophageal echocardiography is widely used in cardiac surgery. Transesophageal echocardiography probe insertion and manipulation can injure the esophagus.

CASE PRESENTATION

A 76-year-old Asian man was admitted to our hospital for coronary artery bypass graft revascularization surgery. A right carotid endarterectomy was successfully performed 2 days before coronary artery bypass graft revascularization surgery. After the coronary artery bypass graft revascularization surgery was done successfully, postoperative computed tomography and esophagography revealed perforation of the middle esophagus. The patient was managed with fasting, parenteral nutrition, and intravenous antibiotics.

CONCLUSIONS

Esophageal perforation can occur with transesophageal echocardiography probe insertion, even without difficulty or resistance, in patients with atherosclerotic disease. Appropriate imaging and vigilance for esophageal injury after a transesophageal echocardiography examination in patients with cardiovascular disease are necessary for appropriate diagnosis and treatment.

摘要

背景

经食管超声心动图在心脏手术中广泛应用。经食管超声心动图探头的插入和操作可能会损伤食管。

病例介绍

一名76岁的亚洲男性因冠状动脉搭桥血管重建手术入住我院。在冠状动脉搭桥血管重建手术前两天成功进行了右侧颈动脉内膜切除术。冠状动脉搭桥血管重建手术成功完成后,术后计算机断层扫描和食管造影显示食管中段穿孔。患者接受禁食、肠外营养和静脉抗生素治疗。

结论

在动脉粥样硬化疾病患者中,即使在插入经食管超声心动图探头时没有困难或阻力,也可能发生食管穿孔。对心血管疾病患者进行经食管超声心动图检查后,进行适当的成像检查并警惕食管损伤,对于正确的诊断和治疗是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c0/5134105/02b5fe19cd6a/13256_2016_1131_Fig1_HTML.jpg

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