16岁男性食管心包瘘的内镜下真空辅助闭合治疗：一例报告
Endoscopic vacuum assisted closure therapy for esophagopericardial fistula in a 16-year-old male: A case report.
作者信息
Muñoz-González Simón, Quejada-Cuesta Samir, González-Arroyave Daniel, Ardila Carlos M
机构信息
Department of Surgery, University of Antioquia, Medellin 050010, Antioquia, Colombia.
Department of Surgery, Pontificia Universidad Bolivariana, Medellín 050031, Antioquia, Colombia.
出版信息
World J Gastrointest Endosc. 2024 Sep 16;16(9):533-539. doi: 10.4253/wjge.v16.i9.533.
BACKGROUND
Esophagopericardial fistula (EPF) is a rare, life-threatening condition with limited scientific literature and no established management guidelines. This case report highlights a successful multidisciplinary approach and the innovative use of endoscopic vacuum assisted closure (endoVAC) therapy in treating this complex condition.
CASE SUMMARY
A 16-year-old male with a history of esophageal atresia and colon interposition presented with progressive chest pain, fever, and dyspnea. Imaging revealed an EPF with associated pleural and pericardial effusions. Initial management with an esophageal stent failed, prompting the use of an endoVAC system. The patient underwent multiple endoVAC device changes and received broad-spectrum antibiotics and nutritional support. The fistula successfully closed, and the patient recovered, demonstrating no new symptoms at a 6-month follow-up.
CONCLUSION
EndoVAC therapy can effectively manage EPF, providing a minimally invasive treatment option.
背景
食管心包瘘（EPF）是一种罕见的、危及生命的疾病，相关科学文献有限，且尚无既定的治疗指南。本病例报告重点介绍了一种成功的多学科治疗方法以及内镜下真空辅助闭合（endoVAC）疗法在治疗这种复杂疾病中的创新应用。
病例摘要
一名16岁男性，有食管闭锁和结肠代食管病史，出现进行性胸痛、发热和呼吸困难。影像学检查显示存在食管心包瘘并伴有胸腔和心包积液。最初使用食管支架治疗失败，遂采用endoVAC系统。患者多次更换endoVAC装置，并接受了广谱抗生素治疗和营养支持。瘘口成功闭合，患者康复，在6个月的随访中未出现新症状。
结论
EndoVAC疗法可有效治疗食管心包瘘，提供了一种微创治疗选择。
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