Sabanathan S, Eng J, Richardson J
Department of Thoracic Surgery, Bradford Royal Infirmary, UK.
Br J Surg. 1994 Jun;81(6):863-5. doi: 10.1002/bjs.1800810623.
Intrathoracic oesophageal rupture is a life-threatening condition that requires early diagnosis and effective treatment if death or serious prolonged illness is to be avoided. Six consecutive patients with intrathoracic oesophageal rupture were treated by debridement and irrigation of the mediastinum and primary suture closure with reinforcement of the suture line by pedicled omentum. The cause of the rupture was Boerhaave's syndrome in five patients and compressed air injury to the oesophagus in one. All but one patient presented more than 24 h after onset of symptoms, with a mean of 38 (range 12-72) h. All the patients recovered well with no postoperative oesophageal leakage. The mean hospital stay was 11.5 (range 9-15) days. Irrespective of the duration of the oesophageal rupture, aggressive resuscitation and prompt primary suture closure with reinforcement of the suture line with a well vascularized pedicled tissue flap is required for optimal results.
胸段食管破裂是一种危及生命的疾病，若要避免死亡或严重的长期疾病，需要早期诊断和有效治疗。连续6例胸段食管破裂患者接受了纵隔清创冲洗及一期缝合，并采用带蒂大网膜加强缝合线。5例患者破裂原因是博雷尔哈夫综合征，1例是食管受压缩空气损伤。除1例患者外，所有患者均在症状出现24小时后就诊，平均为38（12 - 72）小时。所有患者恢复良好，术后无食管漏。平均住院时间为11.5（9 - 15）天。无论食管破裂持续时间长短，为获得最佳效果，均需积极复苏并及时进行一期缝合，并用血运良好的带蒂组织瓣加强缝合线。
