氣管插管併發咽食道破裂－病例報告

Pharyngoesophageal Perforation complicated by Endotracheal Intubation – Case Report

周郁文(Yu-Wen Chou) ； 朱繡棟(Sau-Tung Chu) ； 侯永益(Yu-Yi Hou) ； 楊宜璋(Yi-Chang Yang)

《中華民國耳鼻喉科醫學會雜誌》 33卷5期 (1998/10) Pp. 536-539

https://doi.org/10.6286/1998.33.5.536

摘要

氣管插管時所造成之咽食道破裂在臨床上頗為罕見。本院經驗1例，77歲男性患者，為接受鞏膜扣壓術及玻璃體切除術時實施全身麻醉。術後患者主訴有輕微發燒、咳血、喉嚨痛及頸部腫脹等症狀，乃會診耳鼻喉科。理學檢查發現兩側頸部壓痛，壓迫左頸時有捻髮聲。電腦斷層掃瞄發現氣體廣佈於後咽間隙及兩側側咽間隙。因此懷疑為氣管插管後咽食道破裂。雖經頸部清創術及縫合後咽壁破洞，但口癒合不良。遂改以打開傷口、長期換藥治療，直至咽部破裂處癒合。術後追蹤至今半年，病人情況良好。

關鍵字

氣管插管 ； 咽食道破裂

並列摘要

Pharyngoesophageal perforation caused by oral endotracheal intubation is an unusual case clinically. A 77-year-old male patient suffered from hemoptysis, mild fever, sore throat and neck swelling after receiving sclera buckling and vitrectomy under general anesthesia. In group consultation with otolaryngologists, the physical examination revealed local tenderness over bilateral neck and crepitus over left neck. Computer assisted tomography scan showed emphysema in the posteior pharyngeal and bilateral lateral pharyngeal space. So it was suspected that the patient had a pharyngeal perforation after receiving oral endotracheal intubation. Although incision, debridement and primary closure of a perforated wound at the left lateral pharyngeal wall were performed, the wound healing was poor. Therefore, the wound was reopened and kept on wet dressing on a long term basis until it healed up. The patient was followed up and stable for half a year since completion of the operation.

並列關鍵字

endotracheal intubation ； pharyngoesophageal perforation