Shennib Hani, Baribault Michelle, Heuser Richard
Department of Surgery, College of Medicine, University of Arizona, 6122 33rd St, Paradise Valley, Phoenix, AZ, 85253, USA.
J Cardiothorac Surg. 2021 Oct 13;16(1):300. doi: 10.1186/s13019-021-01670-0.
Large esophageal perforations are challenging and often treated with exclusion or resection. This case demonstrates the feasibility of definitive surgical repair of a large esophageal perforation using large bovine pericardial patch.
A patient with missed Boerhaave Syndrome underwent transesophageal echocardiography causing worsening perforation and sepsis. At thoracotomy and faced with a large esophageal defect, a large Bovine pericardial patch was used for repair with omentopexy. The patient recovered promptly and at 8 months was asymptomatic with satisfactory studies.
Xenograft pericardium is available and widely used for vascular reconstructions. It's use for primary repair of large esophageal perforations should be considered.
巨大食管穿孔具有挑战性，通常采用旷置术或切除术进行治疗。本病例展示了使用大型牛心包补片对巨大食管穿孔进行确定性手术修复的可行性。
一名患有Boerhaave综合征但未得到及时治疗的患者接受经食管超声心动图检查后，穿孔情况恶化并引发脓毒症。开胸手术时发现一个巨大的食管缺损，遂使用大型牛心包补片进行修复并同时行网膜固定术。患者恢复迅速，8个月时无症状，检查结果令人满意。
异种移植心包可获取且广泛应用于血管重建。应考虑将其用于巨大食管穿孔的一期修复。
