Surgery site.
Red Net Moment, March 21 News (Correspondent Pan Zhenghui) Recently, the Department of Otolaryngology and Head and Neck Surgery of Yueyang People’s Hospital, in conjunction with the Department of Cardiology, Department of Anesthesiology and ICU, successfully An elderly patient with myocardial infarction and esophageal foreign body with esophageal perforation underwent “esophageal foreign body removal under general anesthesia”.
The patient’s grandmother Li, 75 years old, accidentally swallowed the jujube pit. At that time, Grandma Li didn’t take it to heart, and only used “earth” methods such as drinking vinegar, swallowing white rice, and eating oranges to try to force the jujube core down. As a result, there was no loosening of the jujube core, and it couldn’t go down or spit out, and there was also pain in swallowing. 10 days later, Grandma Li’s condition became more serious, not only the pain in swallowing was not relieved, but also accompanied by pain in the heart and mouth. She was admitted to a local hospital three days ago and was admitted to the hospital. It was considered as “esophageal foreign body and perforation”. Also, the esophagus has been perforated and the surrounding tissue is significantly swollen. Due to the difficulty of the operation, the patient was immediately transferred to the Department of Otolaryngology, Head and Neck Surgery, Yueyang People’s Hospital.
Su Canjun, the attending physician on duty, received the patient. After completing the examination, it was found that Grandma Li’s condition was more serious than the previous diagnosis: the jujube nucleus is close to the aortic arch and the surrounding tissue is obviously swollen. It is still unclear whether the aortic arch is damaged or not. Sure. The results of electrocardiogram and myocardial cytometry also indicated that grandmother Li suffered from acute myocardial infarction.
Su Canjun immediately notified Ding Zhixiong, deputy director, and informed the Department of Cardiology and Department of Anesthesiology for consultation. Everyone agreed that although the patient’s condition is complicated and the risk of surgery is high, if the patient does not undergo immediate surgery, the patient’s esophageal foreign body infection is likely to lead to mediastinal infection and aortic arch infection, and may even lead to aortic perforation. Once the aorta is perforated, it is easy to cause massive bleeding Causes death, immediate surgery is imminent!
After making relevant preoperative preparations and emergency plans, the patient started the operation at 8:00 pm on the same day. Surgical procedures are dangerous. At the beginning of anesthesia, the patient had abnormally unstable blood pressure and cardiac rhythm, with a high heart rate of 180 and a low heart rate of 40. After emergency treatment by Dr. Yi Han from the Department of Anesthesiology, the heart rhythm and blood pressure gradually stabilized. During the operation, Ding Zhixiong and Su Canjun found that the jujube core had punctured both sides of the esophagus, and the esophagus wall was partially ulcerated at the perforation, and the strong pulsation of the left aortic arch was clearly visible. To break the aortic arch, Ding Zhixiong first pushed the lateral foreign body to the right to keep the foreign body as far away as possible from the aortic arch, and finally carefully removed the foreign body. The operation went smoothly in less than 10 minutes. After inserting a gastric tube, Grandma Li was sent to the ICU for further treatment. At present, the patient has been discharged from the hospital and has recovered very well. He expresses his high recognition and gratitude for the treatment in our hospital.
Experts remind:
Esophageal foreign body is a very common emergency in otolaryngology head and neck surgery, more common in the elderly and children, foreign bodies are mostly fishbone, bone, Date pits, and metal coins are common. Once a foreign body is swallowed and feels stuck in the throat and esophagus, do not swallow it hard with food, because the foreign body may puncture the esophagus or even the large blood vessels around the esophagus under the pressure of food, causing massive bleeding.
The correct way is to swallow some small foreign objects by mistake. If the symptoms are not obvious, you can fast and observe for 12 hours. If the symptoms disappear, return to normal diet. If symptoms persist, seek medical attention immediately. If a large foreign body is swallowed, seek medical attention immediately.