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食管异物致食管穿孔后颈部脓肿及纵隔脓肿的诊治

[The diagnosis and treatment of neck abscess and mediastinal abscess following esophageal perforation induced by esophageal foreign body].

作者信息

Ge X Y, Liu L F, Lu C, Zhang A B, Wang Z X

机构信息

Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Feb;32(4):292-294. doi: 10.13201/j.issn.1001-1781.2018.04.012.

Abstract

The aim of this study is to discuss the clinical presentation, imaging examination and treatment of neck abscess and mediastinal abscess following esophageal perforation induced by esophageal foreign body. Six patients all underwent lateral neck incision and drainage of neck abscess. Simultaneously, mediastinal abscess drainage was performed in 3 cases with mediastinal abscess. All 6 patients were cured. The median time of extraction of gastric tube was 11 days (7-30 days). All patients were not treated with tracheotomy. Neck and chest CT should be done as soon as possible for suspected patients to definite the location of foreign body and the relationship between foreign body and surrounding structures. Patient who were suspected with neck abscess and mediastinal abscess should undergo surgery to remove foreign body and drain the infectious deep neck and mediastinal spaces as early as possible.

摘要

本研究旨在探讨食管异物致食管穿孔后颈部脓肿和纵隔脓肿的临床表现、影像学检查及治疗方法。6例患者均行颈部脓肿切开引流术。同时,3例合并纵隔脓肿患者行纵隔脓肿引流术。6例患者均治愈。胃管拔除的中位时间为11天(7 - 30天)。所有患者均未行气管切开术。对于疑似患者应尽早行颈部和胸部CT检查,以明确异物位置及异物与周围结构的关系。疑似颈部脓肿和纵隔脓肿的患者应尽早行手术取出异物,并对深部颈部和纵隔感染间隙进行引流。

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