食管胃吻合口-胸腔瘘的影像学诊断和介入治疗

The imaging diagnosis and interventional treatment for gastroesophageal anastomosis-thoracic cavity fistula

目的 :探讨食管胃吻合口 胸腔瘘的影像学特征及其介入治疗方法。方法 :回顾性分析 6例具有完整临床资料的食管胃吻合口 胸腔瘘的口服碘水造影及CT表现 ;透视下 ,置入蘑菇状覆膜内支架封堵瘘口。结果 :6例口服碘水造影显示对比剂均经吻合口溢入胸腔 ;6例螺旋CT检查 ,其中 5例显示吻合口与胸腔相通 ,1例瘘口小而未显示。全部病例顺利置入内支架 ,既完全封堵了瘘口 ,又解决了进食问题。结论 :根据口服碘水造影和螺旋CT征象可以诊断食管胃吻合口 胸腔瘘 ,置入蘑菇状覆膜内支架封堵瘘口操作简单、安全、近期疗效明显 。

Objective:To analyse the imaging manifestations and study the treatment for gastroesophageal anastomosis-thoracic cavity fistula.Methods:We analyzed the CT and digital radiography with water-soluble medium in 6 cases with gastroesophageal anastomosis-thoracic cavity fistula retrospectively.Under the fluoroscopic guidance ,mushroom covered stents were placed in 6 patients.Results:Contrast entering into the thoracic cavity through fistula was showed on digital radiography with water- soluble medium and fistula communicating with cavity was showed on 5 CT manifestations.All stents were placed successfully, fistula ora were closed and the food intake ability was improved.Conclusion:The gastroesophageal anastomosis-thoracic cavity fistula could be diagnosed on base of the CT and digital radiography with water-soluble medium.The mushroom covered stent placement is an effective and safe treatment for gastroesophageal anastomosis-thoracic cavity fistula.