BACKGROUND: Complete esophago-gastric necrosis after caustic ingestion is a challenging surgical scenario for reconstruction of the upper digestive transit. AIM: To present a surgical technique for reconstruction of the upper digestive tract after total esophagectomy and gastrectomy due to esophageal and gastric necrosis. METHOD: The transit was re-established by means of a pharyngo-ileo-colic interposition with microsurgical arterial and venous anastomosis for augmentation of blood supply. Colo-duodeno-anastomosis and ileo-transverse colic anastomosis were performed for complete digestive transit reconstruction. RESULT: This procedure was applied in a case of 41 years male attempted suicide by ingesting alkali caustic liquid (concentrated sodium hydroxide). Total necrosis of the esophagus and stomach occurred, which required initially total esophago-gastrectomy, closure at the level of the crico-pharyngeal sphincter and jejunostomy for enteral feeding with a highly deteriorated quality of life . The procedure was performed later and there were no major early and late postoperative complications and normal nutritional conditions were re-stablished. CONCLUSION: The procedure is feasible and must be managed by multidisciplinary team in order to re-establish a normal quality of life.
BACKGROUND: Complete esophago-gastric necrosis after caustic ingestion is a challenging surgical scenario for reconstruction of the upper digestive transit. AIM: To present a surgical technique for reconstruction of the upper digestive tract after total esophagectomy and gastrectomy due to esophageal and gastric necrosis. METHOD: The transit was re-established by means of a pharyngo-ileo-colic interposition with microsurgical arterial and venous anastomosis for augmentation of blood supply. Colo-duodeno-anastomosis and ileo-transverse colic anastomosis were performed for complete digestive transit reconstruction. RESULT: This procedure was applied in a case of 41 years male attempted suicide by ingesting alkali caustic liquid (concentrated sodium hydroxide). Total necrosis of the esophagus and stomach occurred, which required initially total esophago-gastrectomy, closure at the level of the crico-pharyngeal sphincter and jejunostomy for enteral feeding with a highly deteriorated quality of life . The procedure was performed later and there were no major early and late postoperative complications and normal nutritional conditions were re-stablished. CONCLUSION: The procedure is feasible and must be managed by multidisciplinary team in order to re-establish a normal quality of life.
Authors: Kenneth A Kesler; Saila T Pillai; Thomas J Birdas; Karen M Rieger; Ikenna C Okereke; DuyKhanh Ceppa; Juan Socas; Sandra L Starnes Journal: Ann Thorac Surg Date: 2013-02-21 Impact factor: 4.330
Authors: John W Briel; Anand P Tamhankar; Jeffrey A Hagen; Steven R DeMeester; Jan Johansson; Emmanouel Choustoulakis; Jeffrey H Peters; Cedric G Bremner; Tom R DeMeester Journal: J Am Coll Surg Date: 2004-04 Impact factor: 6.113