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一名无持续症状的青少年复发性气管食管瘘:病例报告

Recurrent tracheoesophageal fistula in an adolescent without persistent symptoms: A case report.

作者信息

Lin Jun-Hong, Deng Li, Li Xing

机构信息

aDepartment of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University bDepartment of Medical Oncology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.

出版信息

Medicine (Baltimore). 2017 Nov;96(46):e8668. doi: 10.1097/MD.0000000000008668.

Abstract

RATIONALE

Congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) ininfants have been treated well with surgery. Approximately 10% of children displayed recurrent fistula. In the present case, we reported recurrent TEF in an adolescent as a complication of EA/TEF in infancy.

PATIENT CONCERNS

An infant was diagnosed with gross type C congenital EA and TEF and subsequentlyunderwent repair in early infancy, with division of the TEF and primary esophageal anastomosis. Postoperative esophageal strictures developed and were relieved by bougienage of the esophagus partially. Then, the child had normal growth with mild symptoms, mainly choking when drinking water. At 11 years of age, the child developed fever and cough, and massive bronchiectasis in lobus inferior pulmonis sinister was found.

DIAGNOSIS

Recurrent tracheoesophageal fistula.

INTERVENTIONS

Division of the TEF and esophageal replacement with gastric tube was performed as treatment OUTCOMES:: The child recovered well.

LESSONS

Recurrent tracheoesophageal fistula aftercongenital EA and TEF could be diagnosed in adolescence. Massive bronchiectasis might develop without apparent symptoms.

摘要

原理

婴儿先天性食管闭锁(EA)和气管食管瘘(TEF)已通过手术得到良好治疗。约10%的儿童会出现复发性瘘。在本病例中,我们报告了一名青少年复发性TEF,作为婴儿期EA/TEF的并发症。

患者情况

一名婴儿被诊断为C型先天性EA和TEF,随后在婴儿早期接受修复,切断TEF并进行食管一期吻合。术后出现食管狭窄,部分通过食管扩张术缓解。然后,孩子生长正常,症状较轻,主要是饮水时呛咳。11岁时,孩子出现发热和咳嗽,发现左下肺有大量支气管扩张。

诊断

复发性气管食管瘘。

干预措施

进行TEF切断和胃管食管置换术作为治疗方法。

结果

孩子恢复良好。

经验教训

先天性EA和TEF后的复发性气管食管瘘可在青少年期诊断。可能在没有明显症状的情况下发生大量支气管扩张。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b2b/5704839/5e0dd57840e2/medi-96-e8668-g001.jpg

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