无症状期后出现胸中部疼痛、哨兵动脉出血和失血性休克（Chiari三联征）可诊断为动脉-食管瘘：一种危及生命的胃肠道出血原因。
Midthoracic Pain, Sentinel Arterial Haemorrhage and Exsanguination after a Symptom-Free Interval (Chiari's Triad) is Diagnostic of Arterio-Oesophageal Fistula: A Life-Threatening Cause of Gastrointestinal Bleeding.
作者信息
Glodean Andra, Grobholz Rainer, El-Hag Karim, Ziaka Mairi, Schmid Jean-Paul
机构信息
Department of Internal Medicine, Clinic Barmelweid, Barmelweid, Switzerland.
Institute of Pathology, Cantonal Hospital Aarau, Aarau, Switzerland.
出版信息
Eur J Case Rep Intern Med. 2021 Feb 23;8(3):002134. doi: 10.12890/2021_002134. eCollection 2021.
INTRODUCTION
Arterio-oesophageal fistulae are a very uncommon cause of severe gastrointestinal bleeding, and mostly result from an aberrant right subclavian artery and mediastinal surgery or prolonged endotracheal/nasogastric intubation.
MATERIAL AND METHODS
We present the case of a patient with an oesophageal adenocarcinoma and haematemesis due to a subclavian arterio-oesophageal fistula after mediastinal radiotherapy.
CONCLUSION
We discuss the rare, life-threatening condition of acute erosion of the left subclavian artery caused by an oesophageal tumour and presenting with Chiari's triad.
LEARNING POINTS
Subclavian arterio-oesophageal fistula is an uncommon, life-threatening cause of gastrointestinal bleeding.Knowledge of Chiari's triad enables early recognition of potentially fatal gastro-intestinal bleeding.A high level of suspicion is essential for prompt diagnosis and referral for surgical treatment especially in patients with malignancies of the upper gastrointestinal tract.
引言
动脉-食管瘘是严重胃肠道出血的一种非常罕见的病因，主要由异常的右锁骨下动脉以及纵隔手术或长时间气管插管/鼻胃管插管引起。
材料与方法
我们报告了一例食管腺癌患者，在纵隔放疗后因锁骨下动脉-食管瘘出现呕血的病例。
结论
我们讨论了由食管肿瘤引起的左锁骨下动脉急性侵蚀这种罕见且危及生命的情况，并伴有基阿里三联征。
学习要点
锁骨下动脉-食管瘘是胃肠道出血的一种罕见且危及生命的病因。了解基阿里三联征有助于早期识别潜在致命的胃肠道出血。高度怀疑对于及时诊断并转诊进行手术治疗至关重要，尤其是对上消化道恶性肿瘤患者。
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