Demura Y, Okamura S, Nakanishi M, Touda G, Akai M, Ameshima S, Sasaki F, Ishizaki T, Miyamori I
Third Department of Internal Medicine, Fukui Medical University.
Nihon Kokyuki Gakkai Zasshi. 1998 Nov;36(11):989-93.
An 82-year-old man was admitted to our hospital with high fever and back pain. He already suffered from esophageal carcinoma and expandable metallic stent had been inserted because of esophageal stenosis. A chest x-ray film obtained on admission showed infiltrative shadows in the right lower lung filled. The diagnosis of lung abscess was made on the basis of aspirate findings. Despite closed drainage, antibiotic treatment, and fasting therapy, progressive pulmonary infiltrates developed. Esophagography and esophagoscopy revealed that an esophageal fistula due to an advanced esophageal carcinoma had caused the lung abscess. An additional covered self-expandable metallic stent (EMS) was placed on the surface of the esophageal carcinoma, close to the esophageal fistula. This promptly resolved the lung abscess. Our conclusion was that the covered-EMS can be effective for the palliation of esophagorespiratory fistulas.
一名82岁男性因高热和背痛入院。他已患有食管癌，因食管狭窄已置入可扩张金属支架。入院时拍摄的胸部X光片显示右下肺有浸润性阴影。根据抽吸结果诊断为肺脓肿。尽管进行了闭式引流、抗生素治疗和禁食治疗，但肺部浸润仍进展。食管造影和食管镜检查显示，晚期食管癌导致的食管瘘引起了肺脓肿。在靠近食管瘘的食管癌表面又放置了一个带膜自膨式金属支架（EMS）。这迅速治愈了肺脓肿。我们的结论是，带膜EMS对食管呼吸道瘘的姑息治疗可能有效。
