博尔哈夫综合征因食道静脉破裂而复杂:一个病例报告
Kosei Uehara1, Makoto Sohda2,3, Kengo Kuriyama
1Department of General Surgical Science, Division of Gastroenterological Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, 371-8511, Japan.
General thoracic and cardiovascular surgery cases
|November 7, 2025
概括
这一案例突出了Boerhaave综合征的罕见实例,在肝硬化患者中与食道静脉破裂同时发生. 使用T管排水的手术干预成功地治疗了这两种情况.
科学领域:
- 胃肠病学 胃肠病学
- 胸部外科手术 胸部外科手术
- 肝病学 肝病学是一种肝病学.
背景情况:
- 波尔哈夫综合征,自发食道破裂和食道瘤破裂在肝硬化患者通常是独立管理.
- 这两种危及生命的疾病的同时存在是非常罕见的,并带来了重大管理挑战,特别是在感染控制和门高血压中静血方面.
- 门性高血压是肝硬化的一个常见并发症,增加了食道静脉的风险,可以破裂.
研究的目的:
- 报告一个罕见的Boerhaave综合征病例,由食道静脉破裂复杂化.
- 讨论与这种罕见组合相关的诊断和治疗挑战.
- 强调认识到食道静脉和食道破裂之间的潜在关联的重要性.
主要方法:
- 一份病例报告显示,一名51岁的男性患有肝硬化 (Child-Pugh B级) 病例,并有内视静脉带病史.
- 呈现出血和吐,随后进行CT扫描,显示中肺气和食道穿孔.
- 用T管放置食道撕裂的紧急手术修复用于排水和感染控制.
主要成果:
- 患者因35毫米的食道下部撕裂和活跃的水出血而接受紧急手术.
- 术后管理包括T管排水,有效控制感染和出血.
- 患者经历了无事件的恢复,在术后17日恢复了口服,并在46日出院.
结论:
- 这一案例强调了Boerhaave综合征与食道静脉破裂之间罕见但至关重要的关联.
- 使用T管的手术管理在治疗食道穿孔和水出血方面都被证明是有效的.
- 提高对这种潜在并发症的认识对于快速诊断和食道静脉瘤患者的有效治疗至关重要,特别是在吐后.
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