Deng Liang-Ji, Xiong Jie, Zhong Li-Li, Lin Xiao-Juan, Xiao Xu-Ping, Mao Zhi-Qun
First Affiliated Hospital of Hunan Normal University/Hunan Provincial Key Laboratory of Pediatric Respiratory Medicine, Children's Medical Center of Hunan Provincial People's Hospital, Changsha 410005, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Jun 15;24(6):705-710. doi: 10.7499/j.issn.1008-8830.2202002.
A boy, aged 11 years, was admitted due to intermittent fever for 15 days, cough for 10 days, and "hemoptysis" for 7 days. The boy had fever and cough with left neck pain 15 days ago, and antibiotic treatment was effective. During the course of disease, the boy developed massive "hemoptysis" which caused shock. Fiberoptic bronchoscopy revealed a left pyriform sinus fistula with continuous bleeding. In combination with neck and vascular imaging examination results, the boy was diagnosed with internal jugular vein injury and thrombosis due to congenital pyriform sinus fistula infection and neck abscess. The boy was improved after treatment with temperature-controlled radiofrequency ablation for the closure of pyriform sinus fistula, and no recurrence was observed during the follow-up for one year and six months. No reports of massive hemorrhage and shock due to pyriform sinus fistula infection were found in the searched literature, and this article summarizes the clinical features, diagnosis, and treatment of this boy, so as to provide a reference for the early diagnosis of such disease and the prevention and treatment of its complications.
一名11岁男孩因间歇性发热15天、咳嗽10天、“咯血”7天入院。该男孩15天前出现发热、咳嗽伴左颈部疼痛,抗生素治疗有效。病程中,男孩出现大量“咯血”并导致休克。纤维支气管镜检查显示左侧梨状窦瘘伴持续性出血。结合颈部及血管影像学检查结果,诊断为先天性梨状窦瘘感染并颈部脓肿致颈内静脉损伤及血栓形成。经温控射频消融闭合梨状窦瘘治疗后病情好转,随访1年6个月无复发。检索文献未发现因梨状窦瘘感染导致大量出血及休克的报道,本文总结该男孩的临床特点、诊断及治疗,为该病的早期诊断及并发症的防治提供参考。