儿童异物误食后动脉食管瘘的血管内诊断和治疗:两个病例的故事

Claire E. White-Dzuro , Bryan D. Steitz , Eunice Y. Huang , Christopher M. Baron , Lyndy Wilcox , Jamie R. Robinson
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引用次数: 0

摘要

导言动脉食管瘘(AEF)是动脉与食管之间的异常沟通。虽然这是一种罕见的并发症,但患者面临着灾难性大出血的风险。本研究旨在强调儿童 AEF 的血管内治疗方案。两名患儿均为女性,年龄均在 3 岁或 3 岁以下,就诊时均有吐血症状。每名患者都通过放射线检查证实了食管异物嵌顿,并立即进行了手术。一个由小儿外科、小儿耳鼻喉科、小儿心胸外科和小儿介入放射科组成的多学科团队参与了这两名患者的治疗。在经过数小时的开放性剥离和控制出血尝试失败后,血管造影术成功定位了两名患者的 AEF。此外,血管造影栓塞术成功控制了一名患者的出血。结论:我们的研究强调了多学科团队护理 AEF 患者的重要性,以及血管内技术在帮助快速诊断和潜在处理瘘管方面的作用。
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Endovascular diagnosis and treatment of arterio-esophageal fistula after foreign body ingestion in children: A tale of two cases

Introduction

An arterio-esophageal fistula (AEF) is an abnormal communication between an artery and the esophagus. While a rare complication, patients are at risk of disastrous hemorrhage. The goal of this study is to highlight endovascular management options of AEF in children.

Case series

We present two cases of children with AEF. Both children were female, 3 years of age or younger, and had hematemesis upon presentation. For each patient, esophageal foreign body impaction was confirmed with radiography prompting emergent surgery. A multidisciplinary team was involved in the management of both patients, consisting of combinations of pediatric surgery, pediatric otolaryngology, pediatric cardiothoracic surgery and pediatric interventional radiology. Angiography successfully localized the AEF in both patients after several hours of unsuccessful open dissection and failed attempts at hemorrhage control. Further, angiographic embolization successfully controlled the hemorrhage in one patient. One of the two children experienced cardiac arrest intraoperatively due to hemorrhagic shock, which resulted in their death.

Conclusion

Our study highlights the importance of a multidisciplinary team to care for patients with AEF and the role of endovascular techniques in aiding rapid diagnosis and potential management of the fistula.
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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
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