[食管异物引起的主动脉损伤的血管内修复:一例病例报告]。

Q4 Medicine Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-03-01
Masahito Saito, Hiroki Nakamura, Ryohei Tsuji, Naoki Asano, Kazunori Ota, Kazuho Niimi, Hironaga Ogawa, Kei Torikai, Hiroshi Takano, Koichi Toda
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引用次数: 0

摘要

一名 51 岁的男子因胸部不适和吐血到我院就诊。他被诊断为马洛里-魏斯综合征,并在门诊接受了随访。一周后,他因发热和不适再次到我院就诊。胸部计算机断层扫描(CT)显示,食管上段纵隔有异物穿孔,他被紧急送往医院进行食管异物手术切除。手术前,他呕吐出食管异物,并伴有大量血液。吐血自行停止,对比增强 CT 显示主动脉弓远端有一个假性动脉瘤,因此进行了胸腔内主动脉血管修补术(TEVAR)以防止破裂。食管内镜检查发现食管损伤部位已自愈,因此患者接受了抗生素保守治疗。患者于术后第 18 天顺利出院。在我们的病例中,TEVAR 是治疗食管异物引起的主动脉损伤的有效方法。
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[Endovascular Repair of Aortic Injury Caused by Esophageal Foreign Body:Report of a Case].

A 51-year-old man visited to our hospital because of chest discomfort and hematemesis. He was diagnosed with Mallory-Weiss syndrome and followed in outpatient clinic. One week later, he visited our hospital again for fever and discomfort. Chest computed tomography (CT) showed a foreign body perforated in the mediastinum in the upper esophagus, and he was urgently hospitalized for surgical removal of esophageal foreign body. Before surgery he vomited the esophageal foreign body with a lot of blood. Hematemesis was stopped spontaneously and contrast-enhanced CT revealed a pseudoaneurysm in the distal aortic arch, so thoracic endovascular aortic repair (TEVAR) was performed to prevent rupture. Esophageal endoscopy found that the site of esophageal injury healed spontaneously, so the patient was followed conservatively with antibiotics. He was discharged on postoperative day 18 uneventfully. TEVAR was an effective treatment for aortic injury caused by esophageal foreign body in our case.

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