A Case of Aortoesophageal Fistula Treated by Aortic Graft with Omental Flap Transposition on Condition that Two-stage Esophageal Reconstruction was Followed
نویسندگان
چکیده
症例は69歳の女性.上行大動脈置換の既往がある.今回,下行大動脈瘤に生じた下縦隔の大動脈食道瘻に対し,胸腹部大動脈置換に加え,食道切除二期再建を実施した.第一期手術では右半側臥位・左開胸開腹による胸腹部大動脈置換,食道亜全摘,大網充填,頸部食道瘻造設,胃瘻造設を施行した.大網皮弁作成においては,後日の胃管再建のために右胃大網動静脈を胃側に温存し,左胃大網動静脈をpedicleとする大網皮弁を食道裂孔経由で胸腔内に挙上した.第二期手術では大網皮弁のPedicleである左胃大網動静脈を損傷しないよう,同動静脈を胃壁に沿って処理したうえ胃管を受動し,胸壁前経路で挙上再建した.術後は縫合不全を合併し経過がやや遷延したが,重篤化することなく自宅退院が可能であった.左胃大網動静脈をpedicleとする大網皮弁作成は,後縦隔への大網充填と二期的な胃管による食道再建を両立させる有用な方法であると考えられた.
منابع مشابه
Successful Endovascular Repair of Mycotic Aortic Pseudoaneurysm Followed by Aortoesophageal Fistula
Mycotic aneurysm of the aorta is a rare, but life-threatening pathology. In recent years, endovascular stent graft placement has been introduced as an effective alternative for treating infected aortic aneurysms. A 64-year-old woman with a history of paraplegia due to spinal cord injury was referred to our institute with fever and blood-tinged sputum. Computed tomography (CT) scan showed an 11-...
متن کاملAortoesophageal fistula with a history of graft treatment for thoracic aortic aneurysm.
Aortoesophageal fistula (AEF) is a rare but fatal cause of gastrointestinal hemorrhage, being most commonly associated with thoracic aortic aneurysm. We present a rare case of secondary AEF post graft treatment for mycotic aneurysm of thoracic aorta 4 years previously. Massive upper gastrointestinal hemorrhage resulted in difficult diagnosis by gastrointestinal endoscopy. Computed tomography an...
متن کاملA rare case of prosthetic aortic valve endocarditis complicated with multiple fistula to peri aortic structure
Multiple aorto-cardiac cavity communications is very rare but important complication of prosthetic aortic valve endocarditis. The case below illustrates multiple aorto-cardiac cavity fistula formation following prostethic aortic valve endocarditis presented with slowly progressive symptoms of heart failure. A brief review of surgical reconstruction and the existing literature are presented, i...
متن کاملSurvival following Treatment of Aortoesophageal Fistula with Dual Esophageal and Aortic Intervention
Aortoesophageal fistulas are a rare but commonly fatal complication of esophageal cancer. Reports of successfully managed cases are few, with high mortality and morbidity usually resulting from failure to control the initial massive haemodynamic insult. We report the case of a 47-year-old Caucasian man with recently diagnosed advanced esophageal cancer who suffered an episode of massive haemate...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association)
سال: 2022
ISSN: ['1345-2843', '1882-5133']
DOI: https://doi.org/10.3919/jjsa.83.844