Successful Medical Treatment of Pulmonary-Gastric Fistula

保守治療成功治癒肺胃廔管

李敏思(Min-Si Li) ； 賴炳村(Ping-Tsun Lai)

《童綜合醫學雜誌》 9卷1期 (2015/06) Pp. 66-69

摘要

肺胃瘻管是極為罕見的疾病。這個疾病是因為肺部感染或惡性腫瘤侵入到肋膜，穿過橫隔膜到胃部。我們提出一例40歲男性病患因發燒及膿痰，被診斷左側肺炎併肺膿瘍與膿胸，進一步撿查發現肺胃瘻管。病患無外傷或胸腔、食道、胃部手術病史。上消化道內視鏡無胃癌，潰瘍穿孔，也無腹內敗血症。使用保守治療例如：禁食，抗生素，靜脈營養。病患臨床症狀改善，成功治癒。上消化道攝影也顯示胃底部缺損已癒合，無顯影劑滲漏。

關鍵字

肺胃瘻管 ； 肺膿瘍 ； 膿胸 ； 靜脈營養

並列摘要

Pulmonary-gastric fistulae are extremely rare and can occur secondary to infection or malignancy invading through the lung into the pleural space, through the diaphragm, and into the stomach. A 40-year-old man presented to our facility with left lower lobe lung abscess and thoracic empyema; further investigation revealed a pulmonary-gastric fistula. There was no history of trauma or operation. Upper gastrointestinal endoscopy demonstrated no gastric malignancy or perforated ulcer. Spontaneous closure of the fistula was observed in our patient after thorough conservative management of infection with appropriate antibiotic and parenteral nutrition. Upper gastrointestinal series revealed a healed defect in the gastric fundus without leakage of dye.

並列關鍵字

pulmonary-gastric fistulae ； lung abscess ； thoracic empyema ； parenteral nutrition