Kono T, Kinoshita T, Nakamura T, Inokawa K
Department of Surgery, Iida City Takamatsu Hospital, Nagano, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Oct;44(10):1949-52.
We experienced a case of spontaneous esophageal rupture. A 64-year-old male was admitted to the hospital with shock because of a severe epigastralgia after vomiting. We suspected spontaneous esophageal rupture by the mediastinal air and left pleural effusion of a chest X-ray film of first visit, and diagnosed it by esophagography, then operated 8 hours later the onset. On operation, following the primary closure the esophageal rupture, the pedicled omental flap was applied over the suture site. He complicated renal failure and multiple organ failure, but not leakage postoperatively. In a review of clinical cases seen in the literature, we recommend early operation and the adjunctive use of the pedicled omental flap.
我们遇到了一例自发性食管破裂的病例。一名64岁男性因呕吐后严重上腹痛伴休克入院。首次胸部X线片显示纵隔积气和左侧胸腔积液，我们怀疑为自发性食管破裂，经食管造影确诊，发病8小时后进行手术。手术时，在对食管破裂进行一期缝合后，将带蒂大网膜瓣覆盖于缝合部位。他并发了肾衰竭和多器官功能衰竭，但术后未发生渗漏。回顾文献中所见的临床病例，我们建议早期手术并辅助使用带蒂大网膜瓣。
