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成人先天性食管支气管瘘——1例报告

[Congenital esophago-bronchial fistula in adult--report of a case].

作者信息

Kaneda Y, Sugi K, Nawata S, Esato K

机构信息

First Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1994 Oct;42(10):2003-8.

PMID:7798725
Abstract

A 52-year-old man had been having cough on drinking water since 30 years. He coughed out blood 20 years ago. Chest roentgenogram showed the infiltrating shadow in the right lower lung field and the left hilum. Chest computed tomogram in the left atrium level showed fistulous communication between the bronchus and the esophagus and cavity lesion. Esophagogram showed fistulous communication between the bronchus (rt. B7) and the middle third of the esophagus. Bronchogram showed the stenotic lesion of the right B7a and B*. And abnormal bronchus was revealed and fistula was suspected. The orifice of the fistula was seen by esophageal endoscopy. Through the right posterolateral thoracotomy, fistelectomy and covering with pleural flap over the esophageal suturing site were performed. Histologic finding of the resected specimen revealed fistula's wall composing of smooth muscle lined with squamous cell layer. This case is categorized as Braimbridge type II. The postoperative course was uneventful and the patient is now in free of complaints at the 6th month's P.O.D.

摘要

一名52岁男性自30年前起饮水时就会咳嗽。20年前曾咳出过血。胸部X线片显示右下肺野及左肺门有浸润性阴影。左心房水平的胸部计算机断层扫描显示支气管与食管之间存在瘘管相通及空洞病变。食管造影显示支气管(右B7)与食管中三分之一之间存在瘘管相通。支气管造影显示右B7a和B*存在狭窄病变。发现异常支气管并怀疑有瘘管。通过食管内镜可见瘘口。经右后外侧开胸,进行了瘘管切除术,并在食管缝合部位用胸膜瓣覆盖。切除标本的组织学检查发现瘘管壁由内衬鳞状细胞层的平滑肌组成。该病例归类为布莱姆布里奇II型。术后过程顺利,患者在术后第6个月时无不适主诉。

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