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首页> 外文期刊>Acute and critical care. >Circumferential esophageal perforation resulting in tension hydropneumothorax in a patient with septic shock
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Circumferential esophageal perforation resulting in tension hydropneumothorax in a patient with septic shock

机译：周向食管穿孔导致患者患者患者的张力氢气

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Esophageal perforations occur traumatically or spontaneously and are typically associated with high mortality rates. Early recognition and prompt management are essential. We present the case of a 76-year-old man who was admitted to the medical intensive care unit with fulminant Clostridium difficile colitis, shock, and multi-organ failure. After an initial period of improvement, his condition rapidly deteriorated despite aggressive medical management, and he required mechanical ventilation. Radiography after endotracheal intubation showed interval development of pneumomediastinum and bilateral hydropneumothorax with tension physiology. Chest tube placement resulted in the drainage of multiple liters of dark fluid, and pleural fluid analysis was notable for polymicrobial empyemas. Despite the unusual presentation, esophageal perforation was suspected. Endoscopy ultimately confirmed circumferential separation of the distal esophagus from the stomach, and bedside endoscopic stenting was performed with transient improvement. Two weeks after admission, he developed mediastinitis complicated by recurrent respiratory failure and passed away. This report further characterizes our patient's unique presentation and briefly highlights the clinical manifestations, management options, and outcomes of esophageal perforations.
机译：食管穿孔发生设计或自发地发生，通常与高死亡率相关。早期认可和及时管理至关重要。我们展示了一个76岁男子的案例，患有膨胀性梭菌性结肠炎，休克和多器官衰竭的医学密集护理单位。尽管发生了侵略性的医疗管理，但他的病情迅速恶化，他需要机械通风。内部气管插管后的造影显示肺炎肺炎和双侧湿润的间隔开发，带有张力生理学。胸管放置导致多升暗液的排水，胸腔流体分析对于多元脓肿性脓肿而显着。尽管存在不寻常的介绍，但怀疑食管穿孔。内窥镜检查最终确认了远端食道的周向分离来自胃的远端食管，并且通过瞬时改善进行床边内窥镜支架。入院后两周，他开发了经常性呼吸衰竭并通过了纵隔型复杂的复杂性。本报告进一步表征了我们患者的独特介绍，并简要突出了食管穿孔的临床表现，管理选择和结果。

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