Salo J A, Heikkilä L, Nemlander A, Lindahl H, Louhimo I, Mattila S
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland.
Ann Chir Gynaecol. 1995;84(1):92-4.
15 years after replacement of atretic segment with a gastric tube, perforation of an intrathoracic gastric tube ulcer into the pericardium, oesophago-pericardial fistula and severe mediastinitis developed in a 17-year-old male after reconstruction of oesophageal atresia using a retrosternal Heimlich-tube with a cervical oesophagogastric anastomosis. For six years he suffered from reflux oesophagitis and had Barrett's metaplasia in the cervical oesophagus. The patient had previously had one unsuccessful attempt to correct the oesophageal atresia at the age of two years using transverse colon. The two stage treatment included subtotal oesophagectomy, pericardiotomy, cervical oesophagostomy, gastrostomy, mediastinal and pericardial irrigation with antibiotics. After healing of the mediastinitis, the continuity of the alimentary tract was restored by using an isoperistaltic subcutaneous ileocolic segment. After a follow-up of five years the patient is well, without any oesophageal symptoms.
在使用胃管替代闭锁段15年后，一名17岁男性在采用胸骨后海姆利希管并进行颈段食管胃吻合术重建食管闭锁后，发生了胸内胃管溃疡穿孔进入心包、食管心包瘘和严重纵隔炎。六年来，他一直患有反流性食管炎，颈段食管出现巴雷特化生。该患者曾在两岁时尝试用横结肠矫正食管闭锁，但未成功。两阶段治疗包括次全食管切除术、心包切开术、颈段食管造口术、胃造口术、用抗生素进行纵隔和心包冲洗。纵隔炎愈合后，通过使用等蠕动皮下回结肠段恢复了消化道的连续性。经过五年的随访，患者情况良好，没有任何食管症状。
