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題 名 | Tracheobronchial and Esophageal Rupture after Blunt Chest Trauma--A Case Report=胸部鈍傷導致氣管、支氣管與食道破裂--病例報告 |
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作 者 | 陳秀丹; 王家弘; 陳振德; 吳哲侃; 連德正; | 書刊名 | 胸腔醫學 |
卷 期 | 13:1 1998.03[民87.03] |
頁 次 | 頁71-76 |
分類號 | 416.22 |
關鍵詞 | 車禍; 胸部鈍傷; 氣管破裂; Accident; Tracheal rupture; Esophageal perforation; Computed tomography; |
語 文 | 英文(English) |
中文摘要 | 胸部鈍傷導致的氣管、支氣管與食道破裂是很罕見的,其診斷有賴臨床醫師高度 的警覺性。 此一病例係21歲的年輕男性,戴安全帽騎摩托車發生車禍,送往甲地區醫院一天後轉往乙醫 院,接著再轉到本院急診室,病人有氣促、聲音沙啞、頸部皮下氣腫與手指麻痛等情況。經 氣管鏡與食道鏡檢查發現氣管破裂且食道有破損情形,電腦斷層也顯示氣管破裂,食道上三 分之一與中三分之一部份有管腔擴張且呈不規則現象。經由緊急手術修補,病人於術後二十 一天安然出院,並在神經內科門診繼續追蹤胸椎受傷情形。本病例顯示對於胸部鈍傷患者高 度懷疑其具有氣道與食道破裂之重要性。 |
英文摘要 | A young man injured in a motorcycle accident was transferred to our emergency room due to cervical spine injury and chest contusion. Collar was removed for physical examination. Subcutaneous emphysema and hoarseness were noted. Chest roentgenogram showed pneumomediastinum, deep neck emphysema, and lung contusion but without pneumothorax or rib fracture. Bronchoscopy revealed tracheal rupture 2 cm above the carina and extending to the left main bronchus. Esophagoscopy disclosed ulceration in the left lateral wall of the esophagus around the level of the aortic arch. The computed tomography of chest showed pneumomediastinum over the anterior and middle mediastinum with subcutaneous gas dissection into the lower neck region, upper and middle third esophageal dilatation, and a small communication between the left aspect of the distal trachea and surrounding gas. Emergent right posterolateral thoracotomy with primary repair of trachea and esophagus were performed. The patient was discharged in stable condition 21 days post operation. |
本系統中英文摘要資訊取自各篇刊載內容。