Lu Chen-Yang, Liu Ya-Li, Liu Kui-Jie, Xu Shu, Yao Hong-Liang, Li Lun, Guo Zhu-Shu
Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Central South University, Changsha 410011, Hunan Province, China.
Department of General Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha 410011, Hunan Province, China.
World J Clin Cases. 2022 Jul 26;10(21):7609-7616. doi: 10.12998/wjcc.v10.i21.7609.
Gastrografin swallow, methylthioninium chloride test, and computed tomography (CT) are the main methods for postoperative anastomotic fistula detection. Correct selection and application of examinations and therapies are significant for the early diagnosis and treatment of small anastomotic fistulas after radical gastrectomy, which are conducive to postoperative recovery.
A 44-year-old woman underwent radical total gastrectomy for laparoscopic gastric cancer. The patient developed a fever after surgery. The methylthioninium chloride test and early CT suggested no anastomotic fistula, but gastrografin swallow and late CT showed the opposite result. The fistula was successfully closed using an endoscopic clip. The methylthioninium chloride test, gastrografin, and CT performed on different postoperative dates for small esophagojejunostomy fistulas are different. The size of the anastomotic fistula is an important factor for the success of endoscopic treatment.
The advantages and limitations of the diagnosis of different examinations of small esophagojejunostomy fistulas are noteworthy. The size of the leakage of the anastomosis is an important basis for selecting the repair method.
泛影葡胺吞咽试验、亚甲蓝试验和计算机断层扫描（CT）是术后吻合口瘘检测的主要方法。正确选择和应用检查及治疗方法对于根治性胃切除术后小吻合口瘘的早期诊断和治疗具有重要意义，有利于术后恢复。
一名44岁女性因腹腔镜胃癌接受了根治性全胃切除术。患者术后出现发热。亚甲蓝试验和早期CT显示无吻合口瘘，但泛影葡胺吞咽试验和晚期CT结果相反。通过内镜夹成功闭合了瘘口。对于小食管空肠吻合口瘘，在术后不同时间进行的亚甲蓝试验、泛影葡胺试验和CT结果不同。吻合口瘘的大小是内镜治疗成功的重要因素。
不同检查诊断小食管空肠吻合口瘘的优缺点值得关注。吻合口漏的大小是选择修复方法的重要依据。
