Kirchgatterer A, Punzengruber C, Zisch R, Balon R, Knoflach P
Abteilungen für Interne I, Krankenhaus der Barmherzigen Schwestern, Wels, Osterreich.
Wien Klin Wochenschr. 1998 Feb 13;110(3):101-4.
We present the case of a 45-year-old man who underwent surgical repair of a dissecting aneurysm of the descending thoracic aorta. 25 days postoperatively, the patient unexpectedly developed hematemesis and hypovolemic shock. Emergency gastroscopy was performed and a suspected aortoesophageal fistula was diagnosed. Unfortunately, the patient died prior to emergency surgery. Aneurysms of the aorta or of aortic grafts occasionally lead to the development of fistulae to the upper gastrointestinal tract. Once this rare, but life-threatening complication is suspected, endoscopy must be performed immediately. Emergency surgery is associated with a high risk, but represents the only possibly chance of survival for the patient.
我们报告一例45岁男性患者,其接受了降主动脉夹层动脉瘤的手术修复。术后25天,患者意外出现呕血和低血容量性休克。进行了急诊胃镜检查,诊断为疑似主动脉食管瘘。不幸的是,患者在急诊手术前死亡。主动脉或主动脉移植物的动脉瘤偶尔会导致与上消化道形成瘘管。一旦怀疑这种罕见但危及生命的并发症,必须立即进行内镜检查。急诊手术风险很高,但却是患者唯一可能的生存机会。