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| Abstract |
Peptic ulcer occurring in the gastric conduit for esophageal reconstruction sometimes penetrates into the mediastinal structures. We herein reported a case of pericardial penetration of gastric tube u...lcer successfully treated with thoracoscopic pericardial drainage. A 66-year-old Japanese man, who had undergone esophagectomy for esophageal cancer 20 months before, visited our emergency room complaining severe back pain. Computed tomography revealed gastric tube ulcer penetrated into the pericardial space. Thoracoscopic pericardiotomy and drainage was performed and the patient made an uneventful recovery. Thoracoscopic pericardial drainage is useful to manage acute pyogenic pericarditis due to penetration of peptic ulcer which occurred in the gastric tube.
食道切除再建術後の胃管にできる消化性潰瘍は時として縦隔組織に穿通し, 重篤な合併症を引き起こす. 特に胸骨後経路に拳上された胃管の潰瘍は時として心囊に穿派し, 重篤な心外膜炎や心タンポナーデを引き起こす. 今回われわれは, 心囊に穿通を来した胃管潰瘍に対して胸腔鏡下に心囊切開ドレナージにより治癒しえた1例を経験したので報告する. 症例は66歳男性. 20か月前に食道癌に対して食道切除術を施行し, 胸骨後経路で胃管再建が施行されていた. 急激な胸背部痛を主訴に救急外来を受診し, CTにて胃管潰瘍が心囊に穿派し, 心タンポナーデを来している所見を認めた. 左胸腔経路で胸腔鏡下に心囊切開ドレナージを行い, 術後は合併症なく軽快した. 胸腔鏡下心囊ドレナージは低侵襲で胃管潰瘍の穿通に伴う感染性の心囊液貯留の治療に有用と考えられた.show more
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