在医院间转移之前,应该进行食管镜检查以诊断食管穿孔
Helen J Madsen1, Christina M Stuart1, Brandon M Wojcik1
1Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Journal of thoracic disease
|July 10, 2023
概括
在转移之前对疑似食道穿孔进行食道图,可以防止不必要的患者转移. 这种诊断成像可以降低成本,节约资源,减少食道穿孔病例的管理延迟.
科学领域:
- 医疗成像医学成像
- 胃肠病学 胃肠病学
- 手术诊断手术诊断的使用方法
背景情况:
- 早期识别食道穿孔对于预防发病率和死亡率至关重要.
- 准确的成像诊断有助于对疑似食道穿孔的患者进行分拣.
- 在诊断确认之前,可能会转移稳定的患者,需要对诊断工作流程进行分析.
研究的目的:
- 批判性地分析因疑似食道穿孔而转移的患者的诊断工作流程.
- 为了评估诊断成像在识别食道穿孔的有效性.
- 确定诊断过程中的潜在改进,以减少不必要的转移.
主要方法:
- 65名因疑似食道穿孔而转移的患者的回顾性审查 (2015-2021年).
- 人口统计学分析,参考地点特征,诊断研究和管理.
- 使用威尔科克森-曼-惠特尼和奇平方/费舍尔精确测试进行两变比较.
主要成果:
- 大多数转移 (66.2%) 发生在24小时内;36.9%的转移患者没有食道穿孔.
- 在转移之前,CT成像是常见的 (96.9%),通常显示肺中.
- 在转移前获得食道图仅在21.5%的病例中.
结论:
- 很大一部分转移的患者缺乏食道穿孔,这一点在抵达时通过食道图得到证实.
- 在呈现部位进行食道图可以防止不必要的转移.
- 实施转移前食道镜可以降低成本,节约资源,并最大限度地减少管理延误.
相关概念视频
Esophageal Perforation-II: Clinical Manifestations and Management
90
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
90
Esophageal Perforation-I: Introduction
127
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
127
Endoscopic Procedures I: Esophagogastroduodenoscopy
204
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
204
Endoscopic Procedures V: ERCP
409
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
409
Upper GI Series: Barium Swallow
517
The Barium Swallow Study, or a Barium Esophagogram, is a diagnostic imaging method used to visualize the upper gastrointestinal (GI) tract, including the esophagus, stomach, and small intestine. It employs barium sulfate, a radiopaque contrast material, to provide clear images of the upper digestive system, helping to identify abnormalities, diseases, or structural issues.
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
517
Esophageal Strictures-I: Introduction
151
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
151


