Montresor E, Mangiante G, Lupi A, Gorla A, Perus G, Falezza G, Modena S, Puchetti V
Istituto di Patologia Chirurgica, Cattedra di Chirurgia Generale, Università degli Studi, Verona.
Chir Ital. 1994;46(3):37-45.
Four cases of iatrogenic rupture of the oesophagus are presented. The site of the lesion was in the cervical tract in 1 case and in the thoracic tract in the other 3 cases. Their etiology was pneumatic endoscopic dilatation for achalasia in 2 cases, endoscopic insertion of a Celestin tube for carcinoma of the thoracic tract of the oesophagus in 1 case, and diagnostic endoscopy in the last one. Instrumental findings were relevant in all cases. All patients underwent surgery. In the patients suffering from achalasia, the rupture was repaired by a patch of the gastric fundus. The patient suffering from carcinoma underwent an oesophageal resection, the one with cervical perforation underwent a mediastinal drainage. There were no deaths or considerable post operating complications. In a patient suffering from achalasia gastro-oesophageal reflux was demonstrated after some months following the operation.
本文报告了4例医源性食管破裂病例。病变部位1例位于颈部食管,3例位于胸段食管。病因分别为:2例因贲门失弛缓症行气囊内镜扩张术,1例因胸段食管癌行Celestin管内镜置入术,最后1例为诊断性内镜检查。所有病例均有器械操作相关表现。所有患者均接受了手术治疗。贲门失弛缓症患者的破裂处用胃底补片修补。食管癌患者行食管切除术,颈部穿孔患者行纵隔引流。无死亡病例或严重术后并发症。1例贲门失弛缓症患者术后数月出现胃食管反流。