一种多步骤的方法来管理复杂的食道穿孔
Shiran Shetty1, Dronamraju Sujay Prabhath1, Balaji Musunuri1
1Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
概括
这个案例突出了复杂的食道穿孔的多步骤内镜方法. 在初始治疗失败时,支架,内镜真空疗法和接关闭的组合成功管理了大型缺陷.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性的手术
- 内镜检查是指内镜检查.
背景情况:
- 食道穿孔呈现出显著的发病率和死亡率.
- 对大型穿孔的最佳治疗方法仍在争论中.
- 像剪贴,支架和接这样的标准干预措施可能不足.
研究的目的:
- 为了证明复杂的食道穿孔需要多步骤内镜方法的必要性.
- 提出一个大型食道穿孔的病例,通过连续的内镜干预来管理.
主要方法:
- 一名85岁的男性患有4厘米的食道中孔,最初用完全覆盖的自扩展金属支架 (SEMS) 进行了支架.
- 在SEMS失败后,使用修改后的装置进行了内膜真空疗法 (ENDOVAC).
- 通过透视镜接和接装置实现了最终的关闭.
主要成果:
- 最初的SEMS放置并没有解决穿孔.
- 恩多瓦克治疗减少了缺陷的大小,但没有完全消除缺陷.
- 接装置成功地关闭了大食道缺陷,由胃谱研究证实.
结论:
- 复杂的食道穿孔可能需要一个连续的,多步骤的内镜策略.
- 内镜真空疗法和接装置是治疗大食道缺陷的宝贵工具.
- 这一案例强调了针对性,逐步的内镜干预在挑战食道穿孔的有效性.
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