Takasaki H, Hadama T, Mori Y, Shigemitsu O, Kimura T, Ono K, Miyamoto S, Sako H, Soeda T, Wada T
Second Department of Surgery, Medical College of Oita, Japan.
Kyobu Geka. 1994 Jan;47(1):79-81.
Aortoesophageal fistula due to ruptured thoracic aortic aneurysm is uncommon, and exhibits extremely high mortality. We experienced two cases of such lesion. The first case showed aneurysm in the aortic arch closed with Dacron patch but leaving the esophageal defect. The patient died of an infection of the patch graft after oral feeding. The second case was demonstrated infected aneurysm of the descending aorta. The patient was rescued by primary operation, replacement of the aorta by an artificial graft and resection of the esophagus, and the secondary operation, reconstruction of the esophagus. We recommend resection of aneurysm and the esophagus as well in the aspect of lower post-operative infection in the graft and of the better prognosis of the lesion.
因胸主动脉瘤破裂导致的主动脉食管瘘并不常见,且死亡率极高。我们遇到了两例这种病变。第一例显示主动脉弓部的动脉瘤用涤纶补片封闭,但食管缺损未处理。患者经口进食后死于补片移植物感染。第二例表现为降主动脉感染性动脉瘤。患者通过一期手术,用人造移植物置换主动脉并切除食管,以及二期手术重建食管而获救。从降低移植物术后感染及改善病变预后的角度出发,我们建议同时切除动脉瘤和食管。