晚期呈现和复杂的课程次要鱼骨诱导食道穿孔在老年患者:一个案例报告
Deepak Sethumadhavan1, Mohamed Zuhail K Peediyakkal1, Nabil Mahmood2
1Critical Care Medicine, Hamad Medical Corporation, Doha, QAT.
Cureus
|December 4, 2025
概括
摄入异物导致食道穿孔是罕见的,但在老年患者中是危险的. 及时诊断和治疗对于预防严重并发症和确保更好的结果至关重要.
科学领域:
- 医学 医学 医学 医学 医学
- 胃肠病学 胃肠病学
- 胸部外科手术 胸部外科手术
背景情况:
- 由于外体摄入而导致食道穿孔是一种罕见但严重的疾病.
- 患有并发症的老年患者有更高的严重并发症风险,如中炎和败血症.
- 延迟诊断和治疗显著增加了发病率和死亡率.
研究的目的:
- 突出挑战和管理由老年患者的异物摄入引起的食道穿孔.
- 在这种情况下,强调早期识别和多学科护理的重要性.
主要方法:
- 一个72岁的女性病例报告,她有糖尿病,高血压和喘病史.
- 在摄入鱼骨5天后出现消化不良和胸痛.
- 诊断成像显示异物和中收藏.
- 手术干预包括胸腔切除,食道修复T管,以及肺部段切除.
- 术后并发症的管理,包括中风和真菌感染.
主要成果:
- 一个鱼骨被确定为食道穿孔的原因.
- 患者出现了显著的术后并发症,包括中风和中腺候群病.
- 管理需要一种多学科的方法,包括气管切除术,抗真菌疗法,VATS排水和食道支架.
- 患者在长时间住院后最终在稳定的状态下出院.
结论:
- 外体穿孔食道,虽然很少见,但需要紧急评估和干预,特别是在老年人.
- 延迟呈现导致复杂的恢复和系统和传染性并发症的风险增加.
- 多学科管理对于优化食道穿孔及其后果患者的治疗结果至关重要.
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