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題名 | 梨狀窩癭管併發急性化膿性甲狀腺炎--病例報告=Piriform Sinus Fistula Complicated with Acute Suppurative Thyroiditis--Case Report |
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作者 | 劉耿僚; 張正權; Liu, Ken-liao; Chang, Cheng-chuan; |
期刊 | 中華民國耳鼻喉科醫學雜誌 |
出版日期 | 19990300、19990400 |
卷期 | 34:2 民88.03-04 |
頁次 | 頁148-151 |
分類號 | 415.931 |
語文 | chi |
關鍵詞 | 梨狀窩癭管; 急性化膿性甲狀腺炎; 甲狀腺功能亢進; Piriform sinus fistula; Acute suppurative thyroiditis; Hyperthyroidism; |
中文摘要 | 由於甲狀腺對於細菌感染有頗高的抵抗性,急性化膿性甲狀腺炎與甲狀腺膿瘍是 臨床上相當少見的甲狀疾病。其發生原因依據新近的文獻報告,常與先天性梨狀窩�硎犌傢� 本報告為 23 歲女性病患,因發燒多日、左前頸部紅腫並有明顯觸痛以及心悸數日而入院診 治。經超音波與電腦斷層掃描顯示左葉甲狀腺與甲狀腺周圍膿瘍,細針抽取細胞學與其他實 驗室檢驗數據呈現急性感染相與甲狀腺功能亢進。經抗生素治療與手術引流後症狀緩解,術 中並發現一�硎犍悒疙郊猁爰◣馱W延伸。 經食道鋇劑 X 光攝影顯示一左側梨狀窩�硎煄C再 行�硎牏蟆ㄢN與左葉甲狀腺切除後追蹤至今達 1 年以上,無復發情形, 也無喉返神經麻痺 ,甲狀腺功能亦呈正常。我們相信梨狀窩�硎猻陘獉_急性化膿性甲狀腺炎與膿瘍的主因,並 與先天性鰓裂或鰓囊異常有關。而暫時性甲狀腺功能亢進乃由急性化膿性甲狀腺炎引起。 |
英文摘要 | Acute suppurative thyroiditis with abscess is a rare disease because of the resistance of the thyroid gland to bacterial infection. Congenital piriform sinus fistula has been reported as a cause of acute suppurative thyroiditis and deep neck abscess. A 23-year-old woman presented with fever, a progressively swollen, tender, erythematous mass over the left anterior neck, and palpitation for several days. Abscess of the left thyroid gland and perithyroid space was noted by sonography and neck computed tomography. Laboratory examinations showed acute infection and hyperthyroidism. The symptoms and signs improved after intravenous antibiotics injections and surgical drainage. A fistulous structure was found in the thyroid gland during surgery. Barium-meal esophagography was performed then, and a fistula from the apex of the left pirlform sinus to the thyroid tissue was noted. A complete fistulectomy and left lobectomy of the thyroid gland was performed. After more than one year of follow up, there has been no recurrence or paralysis of the left recurrent laryngeal nerve, and thyroid function has been normal. The patient is not taking any medication. We propose that piriform sinus fistula resulting from a congenital anomaly of the branchial cleft or pouch was the cause of the acute suppurative thyroiditis with abscess. Hyperthyroidism was transient in this case and resulted from acute infectious inflammation of the thyroid gland. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。