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一例患者多发气消化道瘘保守治疗的罕见病例。

A Rare Case of Conservative Management of Multiple Aerodigestive Fistulas in a Patient.

作者信息

Yadav Abhishek, Saini Vivek, Bhargava Narendra, Bhati Rajendra, Mitrolia Bobby

机构信息

Gastroenterology and Hepatology, Dr. Sampurnanand Medical College, Jodhpur, IND.

Medicine, Maulana Azad Medical College and Lok Nayak Hospital, Delhi, IND.

出版信息

Cureus. 2023 Aug 29;15(8):e44336. doi: 10.7759/cureus.44336. eCollection 2023 Aug.

Abstract

Acquired aerodigestive fistulas include tracheoesophageal fistulas (TEF) and bronchoesophageal fistulas (BEF). Common causes of acquired fistulas are usually malignant in origin. Tubercular tracheoesophageal fistula and bronchoesophageal fistula are rare. The limited availability of literature often presents a challenge in the treatment of tubercular TEF. We present the case of a 47-year-old woman who presented with complaints of progressive dysphagia and epigastric pain. Preliminary investigation showed raised erythrocyte sedimentation rate (ESR) of 65 mm/h and further evaluation by esophagogastroduodenoscopy for dysphagia revealed multiple ulcerated lesions in the esophagus, computed tomography (CT) revealed the presence of tracheoesophageal and bronchoesophageal fistulas with lung consolidation, and histological examination revealed granulomatous inflammation. The symptoms were managed conservatively with anti-tubercular medicine alone and showed good response.

摘要

后天性气消化道瘘包括气管食管瘘(TEF)和支气管食管瘘(BEF)。后天性瘘的常见病因通常源于恶性病变。结核性气管食管瘘和支气管食管瘘较为罕见。关于结核性气管食管瘘的文献有限,这常常给其治疗带来挑战。我们报告一例47岁女性病例,该患者主诉进行性吞咽困难和上腹部疼痛。初步检查显示红细胞沉降率(ESR)升高至65mm/h,针对吞咽困难进行的食管胃十二指肠镜进一步评估显示食管有多处溃疡病变,计算机断层扫描(CT)显示存在气管食管瘘和支气管食管瘘伴肺部实变,组织学检查显示肉芽肿性炎症。仅使用抗结核药物对症状进行保守治疗,效果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d9d/10538862/76c20a1f2186/cureus-0015-00000044336-i01.jpg

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