Ishiyama Koshiro, Nomura Takashi, Suzuki Kotaro, Kawahara Yu, Abe Kazuo, Fukushima Norimasa, Iizawa Hajime
Department of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
Kyobu Geka. 2018 Feb;71(2):107-110.
A 67-year-old man was referred to our hospital because of fever and discomfort of the throat. Gastrointestinal endoscopy revealed hematoma at the middle thoracic esophagus. Computed tomography revealed posterior mediastinal hematoma extending the descending aorta. Bacillus was detected in the blood culture. Aortoesophageal fistula with an infected thoracic aortic aneurysm rupture was diagnosed. First, thoracic endovascular aortic repair (TEVAR) was performed. Resection of the thoracic esophagus and omentopexy was conducted 15 days after TEVAR. Esophageal reconstruction using a gastric tube was performed 43 days after esophagectomy. He has been doing well since then.
一名67岁男性因发热和咽喉不适被转诊至我院。胃肠内镜检查发现胸段食管中段有血肿。计算机断层扫描显示后纵隔血肿延伸至降主动脉。血培养检测到杆菌。诊断为感染性胸主动脉瘤破裂导致的主动脉食管瘘。首先，进行了胸段血管腔内主动脉修复术（TEVAR）。TEVAR术后15天进行了胸段食管切除和网膜固定术。食管切除术后43天采用胃管进行食管重建。从那时起，他的情况一直良好。
