Kelly T R, Mayors D J, Boutsicaris P S
Am Surg. 1982 Jan;48(1):35-8.
Intrathoracic goiter remains an interesting diagnostic and surgical problem. A case of a patient with intrathoracic goiter causing a superior vena cava syndrome which resulted in "downhill" esophageal varices and bleeding is presented. This is the 36th case of reported "downhill" esophageal varices and the ninth to cause massive upper gastrointestinal hemorrhage. Intrathoracic goiter is a rare benign cause of "downhill" esophageal varices and bleeding, which can be completely cured by thyroidectomy. It is advisable to consider the addition of a vertical sternotomy in such instances for easier and safer control of the vast collateral venous drainage encountered during removal of the mediastinal component of the tumor.
胸内甲状腺肿仍然是一个有趣的诊断和外科问题。本文介绍了一例胸内甲状腺肿导致上腔静脉综合征，进而引起“下行性”食管静脉曲张和出血的患者。这是第36例报道的“下行性”食管静脉曲张病例，也是第9例导致大量上消化道出血的病例。胸内甲状腺肿是“下行性”食管静脉曲张和出血的罕见良性病因，可通过甲状腺切除术完全治愈。在这种情况下，建议增加垂直胸骨切开术，以便在切除肿瘤纵隔部分时更容易、更安全地控制大量的侧支静脉引流。
