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因碱液摄入后狭窄行食管支架置入继发获得性良性气管食管瘘:一例报告。

Acquired benign tracheo‑oesophageal fistula secondary to oesophageal stenting for post lye ingestion stenosis: A case report.

作者信息

Bolca Ciprian, Bobocea Andrei, Cosoveanu George, Alexe Mihai, Cadar Genoveva, Balescu Irina, Bacalbasa Nicolae, Gherghiceanu Florentina, Furtunescu Florentina, Radavoi Daniel, Paleru Cristian, Miron Adrian, Cordos Ioan

机构信息

Department of Thoracic Surgery, 'Marius Nasta' National Institute of Pneumology, Bucharest 050159, Romania.

Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke QC J1K 2R1, Canada.

出版信息

Exp Ther Med. 2022 Nov 21;25(1):15. doi: 10.3892/etm.2022.11714. eCollection 2023 Jan.

Abstract

Acquired benign trachea-oesophageal fistula is a rare benign pathological entity with varying aetiologies that most often occurs post-intubation. This case report presents the case of a female patient, 31 years old, admitted to the emergency room with sepsis syndrome following bilateral aspiration pneumonia caused by a large trachea-oesophageal fistula. The fistula was the result of intra-tracheal migration of an oesophageal stent placed for post lye ingestion stenosis. Esophageal diversion and partial resection with oesophageal patch to repair the tracheal defect, under general anaesthesia with ventilation using rigid bronchoscopy and high frequency jet ventilation (HFJV), followed at a later date by esophageal replacement with colic graft were the procedures performed with a view to curing the patient. In conclusion, complex cases always require a tailored approach. It is important to note that HFJV may be applied for a longer period of time and the oesophagus can be used as patch for the posterior tracheal wall in selected cases. Staged surgery is also an option when the patients' poor health status does not permit major surgery.

摘要

获得性良性气管食管瘘是一种病因各异的罕见良性病理实体,最常发生于插管后。本病例报告介绍了一名31岁女性患者的病例,该患者因大型气管食管瘘导致双侧吸入性肺炎,以脓毒症综合征收治于急诊室。该瘘是由于为治疗碱液摄入后狭窄而置入的食管支架在气管内移位所致。在全身麻醉下,使用硬支气管镜和高频喷射通气(HFJV)进行通气,实施食管转流和部分切除并采用食管补片修复气管缺损,随后择期进行结肠移植食管置换术,以期治愈该患者。总之,复杂病例总是需要量身定制的治疗方法。需要注意的是,HFJV可应用较长时间,在特定病例中食管可作为气管后壁的补片。当患者健康状况较差无法耐受大手术时,分期手术也是一种选择。

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