1例巨大左心房患者术中经食管超声心动图检查后发生食管穿孔：回顾性构建的三维成像显示食管出现意外的巨大变形。
A case of esophageal perforation after intraoperative transesophageal echocardiography in a patient with a giant left atrium: unexpectedly large distortion of the esophagus revealed on retrospectively constructed three-dimensional imaging.
作者信息
Kimura Aya, Mori Takashi, Kihara Yuki, Watanabe Chie, Tanaka Katsuaki, Yamada Tokuhiro, Yoshida Atushi, Kawabe Joji, Sakon Yoshito, Sibata Toshihiko, Nishikawa Kiyonobu
机构信息
Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7, Asahi-Machi, Abeno-Ku, Osaka, 545-8586, Japan.
Department of Nuclear Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
出版信息
JA Clin Rep. 2019 Mar 15;5(1):21. doi: 10.1186/s40981-019-0243-0.
BACKGROUND
Esophageal perforation is a rare but serious complication of transesophageal echocardiography (TEE). An enlarged left atrium (LA), which is commonly associated with mitral stenosis (MS), is an under-recognized risk factor for esophageal perforation after intraoperative TEE.
CASE PRESENTATION
We describe a case of TEE-induced esophageal perforation after cardiac surgery in a 79-year-old woman with a giant LA due to MS. Esophageal perforation was detected on postoperative day 6. After surgical repair, the patient gradually recovered with prolonged conservative treatment. Retrospectively constructed three-dimensional chest computed tomography images revealed an unusually distorted esophagus that was possibly vulnerable to injury.
CONCLUSION
A giant LA can markedly distort the esophagus. It should be recognized as a risk factor for TEE-induced esophageal perforation.
背景
食管穿孔是经食管超声心动图（TEE）一种罕见但严重的并发症。左心房（LA）增大通常与二尖瓣狭窄（MS）相关，是术中TEE后食管穿孔一个未得到充分认识的危险因素。
病例报告
我们描述了一例79岁因MS导致巨大LA的女性心脏手术后发生TEE诱发食管穿孔的病例。术后第6天检测到食管穿孔。手术修复后，患者经长期保守治疗逐渐康复。回顾性构建的三维胸部计算机断层扫描图像显示食管异常扭曲，可能易受损伤。
结论
巨大LA可显著使食管扭曲。应将其视为TEE诱发食管穿孔的一个危险因素。
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