中葉肺炎を繰り返した食道気管支瘻の1例  [in Japanese] Repeated Pneumonia in the Middle Lobe Caused by Congenital Bronchoesophageal Fistula  [in Japanese]

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Abstract

中葉肺炎を繰り返した食道気管支瘻 (EBF) の1例を経験した. 症例は52歳女性. 3年前より, 飲食中に増加する咳嗽, 喀痰を自覚していた. 症状の増悪とともに3ヵ月間に2回, 中葉肺炎を繰り返したため, 精査目的にて入院. 病歴及び胸部CTより食道気管支瘻を疑った. 食道造影にて, 中部食道右壁の憩室より右気管支に連なるEBFを認めた. 食道造影直後に施行した気管支鏡にて, バリウムが右上-下葉気管支 (B6) から中間気管支幹に漏出しており, 主に中葉気管支に流入し, 同気管支内に残存している様子が観察された. したがって本症例の中葉肺炎はEBFにより繰り返しているものと推定した. 右中葉, 右S6合併切除術及び病理標本所見より, 本症を食道憩室を伴った先天性EBF (Braimbridge I型) と診断した. I型は本邦では49例報告されているが, 中葉肺炎が契機となって発見された報告はない. 成人の先天性EBFは稀な疾患であるが, 繰り返す肺炎では原因疾患として念頭におく必要があると考えられる.

A 52-year-old woman was admitted to our hospital because of repeated episodes of pneumonia in the middle lobe. She had also experienced coughing during meals. The history and chest CT findings suggested the presence of a bronchoesophageal fistula. An upper GI series revealed a fistula between an esophageal diverticulum and the superior segment bronchus of the right lower lobe. Fiberoptic bronchos-copy done immediately after the upper GI series revealed barium sulfate leaking from the superior segment bronchus of the right lower lobe into the middle lobe bronchus. These findings indicated that the repeated pneumonia in the middle lobe was caused by a congenital bronchoesophageal fistula.<br>Examination of the resected fistula showed that it was a Braimbridge type I bronchoesophageal fistula.<br>Although of at least 49 cases of congenital bronchoesophageal fistulas with esophageal diverticula have been reported in the Japanese medical literature, we know of no previous case in which such a fistula was associated with middle-lobe pneumonia.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 34(12), 1395-1400, 1996-12-01

    The Japanese Respiratory Society

References:  13

Cited by:  2

Codes

  • NII Article ID (NAID)
    10008111961
  • NII NACSIS-CAT ID (NCID)
    AN00187758
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03011542
  • Data Source
    CJP  CJPref  J-STAGE 
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