Matsumiya Hiroki, Tahara Yuki, Shinohara Shinji, Tanaka Fumihiro
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Interdiscip Cardiovasc Thorac Surg. 2023 Jun 1;36(6). doi: 10.1093/icvts/ivad104.
A 50-year-old woman presented with chief complaints of fever and cough. She had a poorly controlled left lung abscess and a history of congenital left diaphragmatic hernia treated 9 years prior with composite mesh. Computed tomography showed suspected fistula formation between the left lower lung lobe and stomach, and the tract was visualized in a contrast study from an upper gastrointestinal endoscope. We suspected a gastrobronchial fistula associated with mesh infection and performed en bloc resection of the mesh and inflamed organ tissue, comprising resection of the left lower lung lobe and left diaphragm, partial gastrectomy, and splenectomy. The diaphragm was reconstructed using the latissimus dorsi and rectus abdominis muscles. To our knowledge, this is the first report describing this treatment strategy for gastrobronchial fistula associated with mesh infection. The patient's postoperative course was favourable.
一名50岁女性因发热和咳嗽为主诉前来就诊。她有一个控制不佳的左肺脓肿，并有9年前用复合补片治疗先天性左膈疝的病史。计算机断层扫描显示左肺下叶与胃之间疑似形成瘘管，上消化道内镜对比检查显示了瘘管通道。我们怀疑是与补片感染相关的胃支气管瘘，并对补片和发炎的器官组织进行了整块切除，包括左肺下叶和左膈肌切除、部分胃切除术和脾切除术。用背阔肌和腹直肌重建膈肌。据我们所知，这是第一份描述这种与补片感染相关的胃支气管瘘治疗策略的报告。患者术后病程顺利。
