Esophageal fistula
Introduction
Introduction Severe complications of cervical spine surgery, esophageal fistula is a serious situation, can be combined with cervical spine surgery, delayed emergence of ready-made, but also due to cervical anterior surgery directly, sometimes due to cervical anterior revision surgery or internal fixation surgery is not careful Separation of scar tissue and accidental injury to the esophagus, there are cases of esophageal fistula caused by chronic ulcerative perforation due to internal fixation loosening or even component shedding. Once the diagnosis is clear, the patient's condition should be given a quick evaluation, ventilation, nutritional status, state of water and electrolyte disorders, and then drainage and remedial surgery should be performed without hesitation. In principle, esophageal atresia or combined with tracheoesophageal fistula should be treated as soon as possible.
Cause
Cause
Cervical operation combined with injury, cervical anterior surgery directly leads to anterior orthopedic surgery or internal fixation surgery without careful separation and scar tissue and accidental injury to the esophagus, fixed loose or even component shedding on the esophagus to form a chronic ulcerative perforation leading to esophageal fistula . The cause of this malformation is unknown. Genetic, environmental and other factors are related to it.
Examine
an examination
Related inspection
Endoscopic examination of endoscopic examination for endoscopic examination
The prodromal symptoms of esophageal fistula are often not systemic, only neck discomfort, swelling and pain, combined with swallowing discomfort; local swelling than the normal side, there is tenderness, but usually the swelling and tenderness after surgery feels normal, it is difficult to attract our attention, The more characteristic signs are that the local skin is dark red and the mass is progressively enlarged.
Diagnosis
Differential diagnosis
1, tracheal esophageal gum-like swelling: patients with esophageal syphilis disease once the gums caused by tracheal (bronchial) esophageal spasm cough every time they eat. In addition, other symptoms of esophagitis and obstruction may also occur.
2, esophageal symmetry enlargement: the X-ray characteristics of the lower esophageal fistula are different from the middle esophageal fistula and the lower esophageal ring, the proximal end of the tendon (head end) is esophageal symmetry expansion, and the distal end (esophageal vestibule area) is double Concave. One of the clinical manifestations of esophageal fistula and esophageal ring. Esophageal web and esophagealring are easily confused with esophageal muscle contraction and stenosis. Strictly speaking, esophageal fistula is a thin (2 ~ 3mm) brittle sacral diaphragm consisting of only the mucosa and submucosa in the esophageal lumen, visible in any part of the esophagus. The esophageal ring is often referred to as a thick, tough, narrow ring of esophageal mucosa and muscular layers. The X-ray findings are indistinguishable, so esophageal fistulas and rings should be identified based on symptoms, signs, X-ray signs, esophageal manometry, and endoscopic biopsy.
