López-Candel E, Castejón Casado J, Sánchez López-Tello C, Jiménez Alvarez C
Servicio de Cirugía Pediátrica, H. G. E. Virgen de las Nieves, Granada.
Cir Pediatr. 1993 Apr;6(2):88-90.
We report two cases of cerebral abscess secondary to esophageal dilations in children with caustic stenosis of the esophagus. High fever and neurological findings postdilation lead us to suspect this complication. Cranial C.T. confirmed the diagnosis. Clinical course was favourable in both patients, with antibioterapy on the first case and combined therapy with surgical drainage and parenteral antibiotics on the second patient. We remark the importance of suspect this complication on the basis of clinical and tomographic findings on the pediatric patients subjected to esophageal dilations. Pathogenic ways of bacterial dissemination from the esophagus to the brain are discussed and reviewed.
我们报告了两例患有腐蚀性食管狭窄的儿童因食管扩张继发脑脓肿的病例。扩张术后出现高热和神经学表现使我们怀疑有此并发症。头颅CT确诊了该诊断。两例患者的临床病程均良好,第一例采用抗生素治疗,第二例采用手术引流联合肠外抗生素治疗。我们强调,对于接受食管扩张的儿科患者,应根据临床和断层扫描结果怀疑此并发症。本文讨论并综述了细菌从食管传播至脑部的致病途径。