Kotsis L, Apáti E, Agócs L, Vadász P
Haynal Imre Egészségtudományi Egyetem, Mellkassebészeti Tanszék.
Orv Hetil. 1995 Jul 9;136(28):1491-5.
In this retrospective study (1981-1993) of 31 cases of esophageal perforations and ruptures circumstances the delay or misdiagnosis with undoubtable influence on the survival have been discussed. The over-all mortality was 16.1% but in cases of early (24 h) perforations or ruptures (12) no patients were lost. The unfavourable consequence of the superficial case history, underestimated pain, incomplete roentgenographic study, diagnostic confusion inadequate surgical exploration and misinterpreted postoperative complications of the formal esophageal surgery are analyzed. The authors emphasized the methods to decrease the number of the false-negative contrast esophagograms as well as the value of the intraoperative endoluminal diluted methylin-blue injection to detect esophageal leak. The early diagnosis is the first prerequisite for a favourable outcome in this life-threatening emergency.
在这项对31例食管穿孔和破裂情况的回顾性研究（1981 - 1993年）中，讨论了延误诊断或误诊对生存率产生的无疑具有影响的情况。总体死亡率为16.1%，但在早期（24小时内）穿孔或破裂的12例病例中，无患者死亡。分析了病史简单、疼痛估计不足、X线检查不完整、诊断混淆、手术探查不充分以及对正规食管手术术后并发症的错误解读所带来的不良后果。作者强调了减少食管造影假阴性数量的方法以及术中腔内注射稀释美蓝检测食管漏的价值。对于这种危及生命的急症，早期诊断是取得良好预后的首要前提。
