肺分画症に伴った先天性食道気管支瘻の1例

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  • A CASE OF CONGENITAL ESOPHAGOTRACHEAL FISTULA WITH SEQUESTRATION OF THE LUNG

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We experineced a case of congenital esophagotracheal fistula with sequestration of the lung.<br> A 39-year-old man was seen at the hospital because of a fever and cough. With close examination the patient was diagnosed as pneumonia and the treatment was started. Because of anemia which was found at the same time, upper gastrointestinal series was performed. An operation was carried out with a diagnosis of esophagotracheal fistula. Operative procedures included resection of the fistula duct, disclosure of the esophageal wall and simultaneous left lower lobectomy. During the operation, an artery running from the descending aorta to S10 was noted. He was diagnosed as associating sequestration of the lung. This case has a Braimbridge type IV of congenital esophagotracheal fistula which satisfied the diagnosis criteria presented by Brunner and Karasawa and others. This entity is very rare, but we had to perform aortography with a suspicion of possible coexistence of sequestration of the lung when the fistula was first detected. In principle the fistula duct should be surgically resected, however, the application of pneumonectomy is still controversial. We have to select, operative procedure carefully.

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