一名16岁女孩的创伤后气管气球样变及气管食管瘘
Posttraumatic Tracheal Ballooning and Tracheoesophageal Window in a 16-Year-Old Girl.
作者信息
Piastra Marco, Meacci Elisa, Galli Jacopo, Picconi Enzo, Morena Tony Christian, Ferrari Vittoria, Paioli Daniela, Conti Giorgio
机构信息
Pediatric Intensive Care Unit and Pediatric Trauma Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Catholic University Medical School, Rome, Italy.
出版信息
Pediatr Pulmonol. 2025 Jun;60(6):e71170. doi: 10.1002/ppul.71170.
BACKGROUND
Tracheoesophageal injury following blunt cervical trauma is a rarely described condition, especially in young patients.
METHODS
Imaging documentation and clinical management of a tracheoesophageal fistula (TEF) associated with significant enlargement of the tracheal lumen occurring in a 16-year-old girl after a road accident was reported.
RESULTS
Due to impaired neurological status, the girl was intubated and underwent a 2-week course of invasive mechanical ventilation. When weaning attempts were made, air leak and tracheal enlargement were noticed, consistent with a wide TEF. Surgical tracheostomy and feeding jejunostomy were performed to promote fistula healing and serial endoscopic evaluations were performed. After 3 months, surgical repair by a vascularized muscular flap allowed to establish esophageal and tracheal continuity, leading to a complete functional recovery.
CONCLUSIONS
Posttraumatic TEF is a rare condition in adolescence and it requires a multi-disciplinary approach for diagnosis and treatment. In this case, a multi-step approach was adopted, eventually achieving a complete resolution.
背景
钝性颈部创伤后气管食管损伤是一种鲜有描述的病症，尤其是在年轻患者中。
方法
报告了一名16岁女孩在道路交通事故后发生的气管食管瘘（TEF）的影像学记录及临床处理情况，该瘘伴有气管腔显著扩大。
结果
由于神经功能状态受损，该女孩接受了插管并进行了为期2周的有创机械通气。在尝试撤机时，发现有漏气和气管扩大，符合广泛的TEF。进行了外科气管切开术和空肠造口术以促进瘘口愈合，并进行了系列内镜评估。3个月后，采用带血管蒂肌瓣进行手术修复，重建了食管和气管的连续性，实现了完全功能恢复。
结论
创伤后TEF在青少年中是一种罕见病症，其诊断和治疗需要多学科方法。在本病例中，采用了多步骤方法，最终实现了完全治愈。
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