当教科书与现实相遇时:一个罕见的Boerhaave综合征病例与Mackler的三位一体
Taiwo Ajani1, Jose Loayza Pintado1, Nayiri Derian1
1University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, USA.
Journal of investigative medicine high impact case reports
|January 23, 2026
概括
这一案例突出了Boerhaave综合征的罕见实例,即自发的食道穿孔,呈现出全麦克勒三位一体. 早期诊断和最少的侵入性手术导致了成功的恢复.
科学领域:
- 胃肠病学 胃肠病学
- 胸部外科手术 胸部外科手术
- 紧急医疗 紧急医疗
背景情况:
- 博尔哈夫综合征是一种自发的食道穿孔,是罕见的,危及生命的,并且由于非特异性症状,经常被误诊.
- 麦克勒三位一体 (吐,胸痛,皮下肺气) 是经典的相关,但很少观察到其全部.
研究的目的:
- 在一个患有性结肠炎的年轻成年人身上,呈现一个完整的麦克勒三合体呈现的Boerhaave综合征病例.
- 强调及时诊断和早期手术干预的重要性,以获得有利的结果.
主要方法:
- 一个32岁的男性出现胸痛和吐的病例报告.
- 诊断工作包括体检和口腔对比增强计算机断层扫描.
- 治疗包括机器人辅助腹腔镜修复,内镜支架和排水.
主要成果:
- 患者呈现了完整的麦克勒三位一体,促进了早期诊断Boerhaave综合征.
- 成功的微创手术修复和术后管理导致9日出院.
- 3个月后实现了完全的放射性康复,同时对轻微的性结肠炎发作进行了同步管理.
结论:
- 麦克勒三位一体的完整呈现,虽然很少见,但可以帮助早期诊断Boerhaave综合征.
- 及时诊断和早期的,最少的侵入性手术管理对于积极的预后至关重要.
- 多学科护理对于管理复杂病例至关重要,包括那些同时患有炎症性肠病的病例.
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