著者

諏訪 大八郎 西野 暢彦 松浦 めぐみ 神谷 欣志 松本 圭五 馬場 恵 田中 達郎 今野 弘之 中村 達 馬塲 正三 青木 克憲

出版者

The Japan Broncho-esophagological Society

雑誌

日本気管食道科学会会報 (ISSN:00290645)

巻号頁・発行日

vol.49, no.4, pp.378-385, 1998-08-10 (Released:2010-10-20)

参考文献数

47

被引用文献数

3 2

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Esophageal perforation is a serious acute disease. In this paper, a case of esophageal perforation by a fish-bone with severe mediastinitis and a cervical abscess is reported.For a 50-year-old male, the diagnosis was made 15 days after he had swallowed a fish-bone, because the symptoms were slight before severe chest pain began. Two esophageal perforations (19-21 cm and 24-31 cm from his initial tooth line) were confirmed by endoscopy. Moreover, mediastinitis and a huge cervical abscess were recognized perioperatively. Most of his esophagus was resected due to the two long perforations, and mediastinal drainage, cervical esophagostomy and gastrostomy were also performed. After the operation, the patient suffered from a severe pyothorax, but he fortunately recovered. 10 months later, an esophageal reconstraction by gastric tube was done. Since fish-bones sometimes cause esophageal perforations and severe complications are often seen, strict follow-up is needed for patients who accidentally swallow them.