Intralesional Steroid Injection in Refractory Esophagojejunostomy Anastomosis Stricture, Short Term Effect: Report of a Case & Literature Review

病灶內類固醇注射治療食道空腸吻口術後，吻合處之頑固性狹窄，短時間療效之初報：一病例報告

林連福(Lien-Fu Lin) ； 何家爽(Ka-Sic Ho) ； 蕭泉豹(Chuan-Pau Siauw) ； 童瑞欽(Jai-Chin Tung)

《中華民國消化系醫學雜誌》 14卷4期 (1997/12) Pp. 344-350

https://doi.org/10.6557/GJTb.199712_14(4).0005

摘要

一27歲男性患者因服用強酸致胃及十二指腸嚴重灼傷；遂進行全胃切除及Roux-en-Y端至側食道空腸造口術，吻合口則是利用自動釘書機式縫合。其後發現吻合部位發生頑固性狹窄；故利用內視鏡氣球擴張術；每週呈次，共五周，唯效果不張；自第六次起，在擴張術的同時使用類固醇於狹窄處之四側進行注射，以此法共進行四次後，追蹤兩月未見狹窄再發生，病人吞嚥困難症狀均得緩解，本文附文獻之回顧。

關鍵字

食道空腸吻口術 ； 食道狹窄 ； 內視鏡擴張術 ； 病灶內類固醇注射

並列摘要

A 27-year-old male patient was admitted with severe injury of stomach and duodenum due to ingestion of strong acid. He underwent total gastrectomy, and Roux-en-Y end-to-side esophagojejunostomy by auto suture EEA stapler 30mm size. He developed stricture at the site of esophagojejunostomy anastomosis. Endoscopic dilatation with through-the-scope (TTS) balloon up to 1.8 cm was performed 5 times per week. But stricture had always recurred to the predilatation size by the time of his return for the next endoscopic dilatation. By the sixth time of endoscopic dilatation, intralesional steriod injection (triamcinolone acetonide) 10mg/mi, 0.5cc was given at each quadrant of the stricture site. This procedure was repeated in a weekly interval, and the effect of persistent post-dilated size at the site of esophagojejunostomy anastomosis was seen at the fourth time of local steroid injection. After that, he had no dysphagia, at least on a short term, for a period of2 months because he was lost to follow up.

並列關鍵字

esophagojejunostomy ； esophageal stricture ； endoscopic dilatation ； intralesional steroid injection