Surgical Treatment for Boerhaave's Syndrome-Report of Two Cases

手術治療不同病程的Boerhaave氏症候群－兩病例報告

方副吉(Fu-Chi Fang) ； 程永隆(Yeung-Leung Cheng) ； 禚靖(Ching Tzao) ； 謝志明(Chih-Ming Hsieh) ； 李世俊(Shih-Chun Lee)

《胸腔醫學》 21卷6期 (2006/12) Pp. 501-505

https://doi.org/10.29806/TM.200612.0004

摘要

Boerhaave氏症候群或自發性食道破裂是一種高死亡率的疾病，從診斷到開始治療的時間對病人的癒後是很重要的因子。我們報告兩例不同病程的Boerhaave氏症候群，並成功地手術治療的經驗。第一例從診斷到立即手術修補治療是從病人開始有症狀的16小時內。另外一例則是超過三天，緊急手術方式是頸部食道造口、胸腔積液引流來控制敗血症，並且在確定破裂處癒合後行頸部食道吻合。這兩病例在術後一年的追蹤均沒有特別併發症發生。

關鍵字

自發性破裂 ； 食道 ； 手術 ； 膿胸

並列摘要

Boerhaave's syndrome, or spontaneous perforation of the esophagus, is a life-threatening disease. The timing of diagnosis and treatment of this disease is an important factor in determining its outcome. We report 2 consecutive cases of Boerhaave's syndrome with different clinical presentations that were observed in our institution. The first patient was diagnosed and received urgent surgical repair of the esophageal perforation within 16 hours after presentation. Another patient was diagnosed after more than 3 days and esophageal diversion and thoracic drainage were performed to control sepsis. A delayed esophageal anastomosis was performed after the perforation had healed. These 2 patients were treated successfully and recovered uneventfully after a 1-year follow-up.

並列關鍵字

spontaneous perforation ； esophagus ； surgery ； empyema