一名 70 岁男子的包裹性纵隔积液。

IF 9.5 1区 医学 Q1 CRITICAL CARE MEDICINE Chest Pub Date : 2024-09-01 DOI:10.1016/j.chest.2024.04.017
Guoqing Zhang,Jindong Li,Xiangnan Li
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引用次数: 0

摘要

一名 70 岁的男性因进行性吞咽困难被诊断为中胸段食管鳞状细胞癌(距离门齿 27-30 厘米),并在当地一家医院接受了胸腔镜食管切除术。术后 4 天,他从重症监护室转出;然而,口饮后颈部切口渗出大量脓性液体,这与颈部吻合口漏一致。后来,患者出现呼吸困难和排痰困难,随后被转回重症监护室接受治疗。CT 扫描显示纵隔和左胸腔有大量积液。胸腔穿刺术取出了淡黄色液体,在放置胸腔闭式引流系统后,患者的全身情况逐渐好转。患者的颈部吻合口瘘持续存在且未愈合,随后被转到我们的医疗中心,并保留了胸腔闭式引流系统。
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A 70-Year-Old Man With an Encapsulated Mediastinal Fluid Collection.
A 70-year-old man was diagnosed with mid-thoracic esophageal squamous cell carcinoma (distance from incisors, 27-30 cm) because of progressive dysphagia and underwent thoracic laparoscopic esophagectomy at a local hospital. He was transferred from the ICU 4 days after surgery; however, a large amount of purulent fluid exuded from the neck incision after oral drinking, which was consistent with cervical anastomotic leakage. Later, the patient experienced difficulty breathing and expelling sputum; he was then transferred back to the ICU for treatment. A CT scan showed massive fluid collection in the mediastinum and left pleural cavity. Thoracentesis yielded yellowish fluid, and the patient's general condition gradually improved after placement of a closed chest drainage system. The patient's cervical anastomotic fistula persisted and did not heal, and he was subsequently transferred to our medical center with the closed chest drainage system left in place.
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来源期刊
Chest
Chest 医学-呼吸系统
CiteScore
13.70
自引率
3.10%
发文量
3369
审稿时长
15 days
期刊介绍: At CHEST, our mission is to revolutionize patient care through the collaboration of multidisciplinary clinicians in the fields of pulmonary, critical care, and sleep medicine. We achieve this by publishing cutting-edge clinical research that addresses current challenges and brings forth future advancements. To enhance understanding in a rapidly evolving field, CHEST also features review articles, commentaries, and facilitates discussions on emerging controversies. We place great emphasis on scientific rigor, employing a rigorous peer review process, and ensuring all accepted content is published online within two weeks.
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