晚期自发性食管破裂诊治1例

Diagnosis and Treatment of Advanced Spontaneous Esophageal Rupture:A Case Report

回顾性分析浙江大学医学院附属邵逸夫医院收治的1例晚期自发性食管破裂患者的临床资料以及诊疗过程。患者因饮酒后突发胸闷气急于当地医院就诊,后转来本院,诊断为自发性食管破裂,采用外科手术清除食物残渣及坏死物质,直视下置入两根胸腔引流管,每日反复冲洗胸腔,持续引流后治愈。结合文献探讨诊疗经验,对于晚期自发性食管破裂,特别是瘘口较大的病例,需积极手术进行胸腔清洗,并且重点设计引流管放置位置,充分引流。

Objective The clinical data and diagnosis and treatment of a patient with advanced spontaneous rupture of esophagus in our hospital were analyzed retrospectively.The patient went to hospital because of sudden chest stuffiness after drinking,and then transferred to our hospital with diagnosis of spontaneous rupture of esophagus.Food residue and necrotic substance were removed by surgery.Two thoracic drainage tubes were placed under direct vision,and the thoracic cavity was washed repeatedly every day.After continuous drainage,the patient was cured.According to the experience of diagnosis and treatment in the literature,it is necessary to wash the thoracic cavity actively for the patients with advanced spontaneous rupture of esophagus,especially the large fistula,and to design the location of drainage tube for adequate drainage.