Semlacher R A, Bharadwaj B B, Nixon J A
Department of Surgery, Foothills Hospital, Calgary, Alberta, Canada.
J Cardiovasc Surg (Torino). 1994 Feb;35(1):83-6.
Tracheo-esophageal (T-E) fistulas secondary to blunt chest trauma are extremely uncommon. Once the diagnosis is confirmed, surgical correction is indicated as spontaneous healing rarely occurs. Should a barium esophagram demonstrate a persistent T-E fistula postoperatively, we suggest that in the absence of clinical or radiological evidence of mediastinal or pulmonary infection, a conservative treatment regimen may be considered in an attempt to resolve the fistula without surgical intervention. Conservative management should be abandoned and surgery indicated if mediastinitis or recurrent aspiration pneumonias occur, or the fistula fails to heal within a four to six week period.
钝性胸部创伤继发的气管食管（T-E）瘘极为罕见。一旦确诊，应进行手术矫正，因为很少会自发愈合。如果钡餐食管造影显示术后存在持续性T-E瘘，我们建议，在没有纵隔或肺部感染的临床或影像学证据的情况下，可考虑采用保守治疗方案，试图在不进行手术干预的情况下解决瘘管问题。如果发生纵隔炎或反复吸入性肺炎，或者瘘管在四到六周内未能愈合，则应放弃保守治疗并进行手术。
