Owens J J, Donovan D T, Alford E L, McKechnie J C, Franklin D J, Stewart M G, Schwartz M R
Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030.
Ann Otol Rhinol Laryngol. 1994 Nov;103(11):838-42. doi: 10.1177/000348949410301102.
Giant fibrovascular polyps of the esophagus and hypopharynx are benign tumors of the upper digestive tract. Although a rare cause of asphyxiation, laryngeal impaction by a regurgitated polyp of the esophagus may be the initial symptom that brings the patient to request medical attention. Two new cases of giant fibrovascular polyps with dramatic and potentially life-threatening presentations illustrate the unpredictable behavior of these unusual tumors. Both patients presented to the emergency center with a history of coughing and eructation followed by temporary airway obstruction that was relieved by clenching a regurgitated fleshy mass between the teeth. Diagnostic and therapeutic intervention requires aggressive airway management, radiographic and endoscopic evaluation, and definitive surgical treatment. Tracheotomy was required in one patient, and successful endotracheal intubation provided satisfactory airway control in the second. Esophagoscopy revealed the origin of both tumors to be near the cricopharyngeal muscle. Complete surgical excision was curative in both cases.
食管和下咽的巨大纤维血管性息肉是上消化道的良性肿瘤。虽然食管息肉反流导致喉部嵌顿是窒息的罕见原因，但这可能是促使患者寻求医疗关注的初始症状。两例表现显著且可能危及生命的巨大纤维血管性息肉新病例说明了这些不寻常肿瘤的不可预测行为。两名患者均因咳嗽和嗳气病史后出现临时气道阻塞而就诊于急诊中心，通过咬紧反流至口腔的肉质肿物可缓解阻塞。诊断和治疗干预需要积极的气道管理、影像学和内镜评估以及确定性手术治疗。其中一名患者需要进行气管切开术，另一名患者成功进行气管插管后气道得到了满意的控制。食管镜检查显示两个肿瘤的起源均靠近环咽肌。两例均通过完整手术切除治愈。
