Smulewicz J J, Guerrero L E, Washington D, Hassani S N
J Natl Med Assoc. 1988 Jul;80(7):817-8, 821.
Malignant tracheoesophageal fistula occurs infrequently in patients with irradiated esophageal and lung cancer, uncommonly in patients with untreated mediastinal malignancies, infection, or trauma, and rarely in primary adenocarcinoma of the lung. The natural progression of this entity leads to rapid deterioration and death from overwhelming pulmonary infection.Definitive treatment depends on the demonstration and localization of the fistula. Computerized tomography (CT) chest scanning with dilute oral contrast is the ideal means of identification of the fistula. CT scanning without contrast may outline sufficiently the pathology to avoid the usage and side effects of contrast media in the lungs.A review of one case of tracheoesophageal fistula due to pulmonary adenocarcinoma is presented where emergency CT scanning without contrast resulted in rapid and accurate diagnosis, leading to prompt and appropriate management.
恶性气管食管瘘在接受过放疗的食管癌和肺癌患者中很少见，在未经治疗的纵隔恶性肿瘤、感染或创伤患者中不常见，在原发性肺癌中则极为罕见。这种疾病的自然发展会导致因严重肺部感染而迅速恶化和死亡。确切的治疗取决于瘘管的显示和定位。口服稀释造影剂的胸部计算机断层扫描（CT）是识别瘘管的理想方法。无造影剂的CT扫描可能足以勾勒出病变情况，从而避免造影剂在肺部的使用及其副作用。本文报道了一例因肺腺癌导致气管食管瘘的病例，其中无造影剂的急诊CT扫描实现了快速准确的诊断，进而促成了及时且恰当的治疗。
