Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Treatment of Esophageal Injury

식도 손상의 치료

  • Sim, Hee-Jae (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Gyeongsang National University, Institute of Health Science, Gyeongsang National University) ;
  • Jang, In-Seok (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Gyeongsang National University, Institute of Health Science, Gyeongsang National University) ;
  • Park, Hyun-Oh (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Gyeongsang National University, Institute of Health Science, Gyeongsang National University) ;
  • Lee, Chung-Eun (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Gyeongsang National University, Institute of Health Science, Gyeongsang National University) ;
  • Kim, Jong-Woo (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Gyeongsang National University, Institute of Health Science, Gyeongsang National University) ;
  • Choi, Jun-Young (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Gyeongsang National University, Institute of Health Science, Gyeongsang National University) ;
  • Rhie, Sang-Ho (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Gyeongsang National University, Institute of Health Science, Gyeongsang National University)
  • 심희제 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교 건강과학연구원) ;
  • 장인석 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교 건강과학연구원) ;
  • 박현오 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교 건강과학연구원) ;
  • 이정은 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교 건강과학연구원) ;
  • 김종우 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교 건강과학연구원) ;
  • 최준영 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교 건강과학연구원) ;
  • 이상호 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교 건강과학연구원)
  • Received : 2010.09.28
  • Accepted : 2010.11.19
  • Published : 2010.12.05
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Abstract

Background: Esophageal injury requires early and proper management. We want to determine the results of various esophageal injuries. Material and Method: We respectively analyzed 22 patients who were managed for esophageal injury between 1999 and 2009. Based on the medical records, we reviewed the causes of injury, the diagnoses, the treatment methods, the complications and the prognosis. Result: The main causes of esophageal injury were a foreign body in 9 cases (41%) and vomiting in 5 cases (23%). We treated the patients with esophageal primary repair in 12 cases (55%), abscess drainage in 4 cases (18%) and conservative management in 6 cases (27%). There was esophageal leakage in 7 cases (32%) and death occurred in 3 cases (14%). Conclusion: For minor esophageal injury, conservative management was sometimes possible to treat the esophagus, yet aggressive and urgent surgical treatment should be applied for cases of major esophageal injury, including mediastinal abscess.

배경: 식도손상은 예후가 나쁘기 때문에, 신속하게 알맞은 치료가 이루어져야 한다. 식도손상의 치료결과에 대하여 알아보고자 하였다. 대상 및 방법: 1999년부터 2009년까지의 10년간 식도손상 환자 22명을 대상으로 병록지를 분석하여 후향적으로 조사하였다. 식도손상의 원인, 주증상, 진단법, 치료방법, 후유증, 예후를 확인하였다. 결과: 손상의 원인은 이물질에 의한 경우가 9예(41%), 구토로 인한 손상이 5예(23%)였다. 치료는 식도일차봉합술이 12예 (55%), 절개배농술이 4예(l8%), 보존적 치료가 6예(27%) 있었다. 치료중 식도 누출이 7예 (32%)에서 있었으며, 사망은 3예(14%) 있었다. 결론: 식도 손상이 경미한 경우 보존적인 치료만으로도 치료성적이 우수하였으며, 식도 주위에 농양이 존재하거나 분명한 식도 손상이 있는 경우 즉시 수술적인 치료가 필요할 것으로 생각된다.

Keywords

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