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主动脉食管瘘继发的移植物周围脓肿

Perigraft Abscess Subsequent to Aortoesophageal Fistula.

作者信息

Takei Norie, Kunieda Takeshige, Kumada Yoshitaka, Murayama Masanori

机构信息

Department of General Internal Medicine, Matsunami General Hospital, Japan.

Department of Cardiovascular Surgery, Matsunami General Hospital, Japan.

出版信息

Intern Med. 2018 Nov 15;57(22):3255-3259. doi: 10.2169/internalmedicine.0493-17. Epub 2018 Jul 6.

DOI:10.2169/internalmedicine.0493-17
PMID:29984765
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6287987/
Abstract

A 79-year-old man with appetite loss and nausea for 1 month was admitted to our hospital. His thoracic aortic aneurysm had gradually increased in size due to perigraft endoleak after the previous aneurysm repair surgery. Although he showed no hematemesis, melena, or a fever, gastrointestinal endoscopy and contrast-enhanced computed tomography (CT) revealed an aortoesophageal fistula (AEF). He developed septic shock due to a perigraft abscess and eventually died, although aortic graft replacement and esophageal transection were performed. Clinical suspicion is the most important factor for obtaining an accurate diagnosis and improving the prognosis in cases of AEF.

摘要

一名79岁男性，因食欲减退和恶心1个月入院。他的胸主动脉瘤在前次动脉瘤修复手术后因移植物周围内漏而逐渐增大。尽管他没有呕血、黑便或发热，但胃肠内镜检查和增强计算机断层扫描（CT）显示存在主动脉食管瘘（AEF）。他因移植物周围脓肿并发感染性休克，尽管进行了主动脉移植物置换和食管横断术，最终仍死亡。临床怀疑是获得AEF准确诊断和改善预后的最重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a623/6287987/d4e8c4957d88/1349-7235-57-3255-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a623/6287987/ff8131472141/1349-7235-57-3255-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a623/6287987/65d09f936b2a/1349-7235-57-3255-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a623/6287987/21e1ba42ac9b/1349-7235-57-3255-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a623/6287987/d4e8c4957d88/1349-7235-57-3255-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a623/6287987/ff8131472141/1349-7235-57-3255-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a623/6287987/65d09f936b2a/1349-7235-57-3255-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a623/6287987/21e1ba42ac9b/1349-7235-57-3255-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a623/6287987/d4e8c4957d88/1349-7235-57-3255-g004.jpg

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本文引用的文献

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J Cardiol Cases. 2012 Jun 6;6(2):e51-e54. doi: 10.1016/j.jccase.2012.05.005. eCollection 2012 Aug.
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Secondary aortoduodenal fistula without gastrointestinal bleeding directly detected by CT and endoscopy.CT和内镜检查直接检测到的无胃肠道出血的继发性主动脉十二指肠瘘。
Radiol Case Rep. 2015 Dec 7;7(4):774. doi: 10.2484/rcr.v7i4.774. eCollection 2012.
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Aortoesophageal fistula after thoracic endovascular aortic repair diagnosed and followed with endoscopy.
与主动脉病变相关的主动脉食管瘘患者死亡的危险因素。
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经胸腔内血管主动脉修复术后主动脉食管瘘的诊断及内镜随访
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Int Surg. 2011 Jul-Sep;96(3):266-73. doi: 10.9738/0020-8868-96.3.266.
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Aortoesophageal fistula after thoracic aortic stent-graft placement: a rare but catastrophic complication of a novel emerging technique.胸主动脉覆膜支架置入术后主动脉食管瘘：一种新型技术罕见但灾难性的并发症。
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Five-year results of endovascular treatment with the Gore TAG device compared with open repair of thoracic aortic aneurysms.使用戈尔TAG装置进行血管内治疗与胸主动脉瘤开放修复的五年结果比较。
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