食管癌合并恶性食管-胸膜-心包瘘1例。

M Wiedmann, A Hagendorff, R Böhm, T Schulz, J Mössner, K Caca
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引用次数: 12

摘要

继发于食道或胃肿瘤的心包及心脏瘘管是一种罕见的并发症。我们报告一例50岁男性患者,因患远端食管癌10个月并有肺、肝转移病史,于2004年3月初接受6周期姑息化疗后转诊至我院。患者表现为吞咽困难、呼吸困难、心动过速和低血压。诊断为化脓性心包和双侧胸腔积液,患者接受抗生素治疗,反复胸腔穿刺和每日polihexanide灌洗心包引流。食管、胃十二指肠镜、吞咽及胸部电脑断层扫描显示恶性食管-胸膜-心包瘘。总共有三个涂层的,可膨胀的金属支架被插入食管,成功地密封了瘘。不幸的是,病人在三个月后死于癌症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Malignant oesophago-pleuro-pericardial fistula in a patient with oesophageal carcinoma.

Pericardial and cardiac fistulae secondary to oesophageal or gastric tumours are a rare complication. We report about a 50-year-old male patient with a 10-month history of distal oesophageal carcinoma with lung and liver metastases who was referred to our hospital after 6 cycles of palliative chemotherapy at the beginning of March 2004. The patient presented with dysphagia, dyspnea, tachycardia, and hypotension. Purulent pericardial and bilateral pleural effusion was diagnosed, and the patient was treated with antibiotics, repeated pleurocentesis and pericardial drainage with daily polihexanide lavage. Oesophagogastroduodenoscopy, Peritrast swallow and computed tomographic scans of chest revealed a malignant oesophago-pleuro-pericardial fistula. A total of three coated, expandable metal stents were inserted into the oesophagus, which sealed successfully the fistula. Unfortunately, the patient succumbed to his carcinoma three months later.

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