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Case Report
Esophageal reconstruction with colon interposition for corrosive esophageal injury
1 MD, General Surgery Department, Matosinhos Health Local Unit (ULSM), Portugal, Faculty of Medicine of Porto University, Porto, Portugal
2 MD, PhD, Head of General Surgery Department, Matosinhos Health Local Unit (ULSM), Faculty of Medicine of Porto University, Porto, Portugal
Address correspondence to:
Pedro Maurício Valente
MD, General Surgery Department, Matosinhos Health Local Unit (ULSM), 4464-513 Senhora da Hora,
Portugal
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Article ID: 100079Z12PV2020
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Valente PM, Quintela AC, Gonçalves JP, Leite BC, Guerreiro E, Gouveia AM. Esophageal reconstruction with colon interposition for corrosive esophageal injury. J Case Rep Images Surg 2020;6:100079Z12PV2020.ABSTRACT
Introduction: Esophageal reconstruction is required to restore digestive continuity after resection of the esophagus and in patients with strictures that are not eligible for or have failed dilation. Colon is the replacement organ of choice when stomach is unavailable.
Case Report: The authors describe a case of a 72-year-old patient who suffered from complete gastric necrosis after premeditated acid ingestion. Emergent total gastrectomy was performed without immediate reconstruction. The patient spent several months under exclusive jejunostomy feeding before readmission to surgical digestive tract reconstruction. An esophageal severe stricture precluded its use and forced a colic interposition. The procedure was successful as well as the postoperative period, and the patient showed overall good functional and nutritional results.
Conclusion: A minimum delay of six months is advised for intestinal reconstruction after a caustic lesion. If a colon conduit is needed, the colon side and the mediastinal route to use should be chosen on a case-by-case basis. A careful colon evaluation, otolaryngology and psychiatry consultations make part of the pre-operative requirements. Although the use of colon interposition is technically demanding and has been associated with high morbidity, it stands as the preferred choice for esophageal replacement in patients without stomach or with gastric pathology. To choose an adequate intervention timing and an appropriate technique increase the chances for a successful reconstruction.
Keywords: Caustic ingestion, Esophageal reconstruction
SUPPORTING INFORMATION
Author Contributions
Pedro Maurício Valente - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
A Catarina Quintela - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
J Pedro Gonçalves - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Bárbara Costa Leite - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Emanuel Guerreiro - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
António M Gouveia - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Pedro Maurício Valente et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
