Hamm B, Altenähr E
Dtsch Med Wochenschr. 1982 Feb 26;107(8):293-8. doi: 10.1055/s-2008-1069920.
The morphological changes in the distal oesophagus occurring after tube treatment, sclerosis and/or shunt operation for acutely bleeding oesophageal varices were investigated in 29 post mortems between March 1979 and April 1980. In addition three oesophagi were investigated after sclerosis several months previously. As was to be expected the oesophagi showed no specific changes after recent porto-caval shunts. In contrast there were definite histological differences after tube treatment as opposed to sclerosis. After compression tubes the oesophagi showed focal pressure necroses and ulcers. In the sclerosed oesophagi there frequent widespread, partially transmural, necroses, suppurative inflammation of the oesophageal wall and mediastinitis. Serious complications occurring after sclerosis were perforation with mediastinal abscess, pleuritis and severe paraoesophageal haemorrhage. In the prevention of complications after sclerosis both the injection technique and the choice of sclerosing agent are important.
1979年3月至1980年4月间,对29例因急性出血性食管静脉曲张接受插管治疗、硬化治疗和/或分流手术的患者进行了尸检,研究了其远端食管的形态学变化。另外,对3例数月前接受硬化治疗的食管进行了研究。正如预期的那样,近期门腔分流术后食管未出现特异性变化。相比之下,插管治疗与硬化治疗后在组织学上存在明显差异。压迫插管后,食管出现局灶性压迫性坏死和溃疡。硬化治疗后的食管则频繁出现广泛的、部分透壁的坏死、食管壁化脓性炎症和纵隔炎。硬化治疗后发生的严重并发症包括伴有纵隔脓肿的穿孔、胸膜炎和严重的食管旁出血。在预防硬化治疗后的并发症方面,注射技术和硬化剂的选择都很重要。