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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.

DOI:10.4253/wjge.v16.i9.533
PMID:39351174
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11438585/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf8b/11438585/d0f5f1af08e6/WJGE-16-533-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf8b/11438585/47c82743d361/WJGE-16-533-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf8b/11438585/1b9083e91950/WJGE-16-533-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf8b/11438585/d0f5f1af08e6/WJGE-16-533-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf8b/11438585/47c82743d361/WJGE-16-533-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf8b/11438585/1b9083e91950/WJGE-16-533-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf8b/11438585/d0f5f1af08e6/WJGE-16-533-g003.jpg

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本文引用的文献

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Esophagopericardial Fistula: The Wolf in Sheep's Clothing.食管心包瘘:伪装成羊的狼。
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Esophagopericardial Fistula Following Radiofrequency Ablation for Atrial Fibrillation: Insights Into Its Management.心房颤动射频消融术后食管心包瘘:治疗体会
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Case report of a 72-year-old man with diaphragmatic hernia and thoracic gastropericardial fistula after esophagectomy for 18 years.
18 年前因食管癌行手术后出现膈疝和胸胃心包瘘的 72 岁男性病例报告。
J Cardiothorac Surg. 2021 Jul 7;16(1):193. doi: 10.1186/s13019-021-01574-z.
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Esophagopericardial Fistula After Esophagectomy.食管切除术后食管心包瘘
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Modified vacuum-assisted closure (EndoVAC) therapy for treatment of pharyngocutaneous fistula: Case series and a review of the literature.改良负压封闭引流(EndoVAC)疗法治疗咽皮肤瘘:病例系列及文献综述
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Management of Tumor- and Nontumor-related Aorto-esophageal and Aorto-bronchial Fistulas.肿瘤和非肿瘤相关的主动脉-食管和主动脉-支气管瘘的处理。
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Endoluminal vacuum-assisted closure (E-Vac) therapy for postoperative esophageal fistula: successful case series and literature review.腔内真空辅助闭合(E-Vac)治疗术后食管瘘:成功病例系列和文献复习。
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