A case of corrosive esophagitis causing extensive cicatricial esophageal stenosis treated by esophageal bypass with supercharged pedicled jejunal pull-up
| Autor: | Masaaki Saito, Toshiki Rikiyama, Erika Machida, Jun Takahashi, Hirokazu Kiyozaki, Iku Abe, Tamotsu Obitsu, Yuta Muto |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Corrosive esophagitis Alkali ingestion business.industry medicine.medical_treatment Anastomosis Corrosive substance Article Surgery Pedicled jejunal bypass 03 medical and health sciences 0302 clinical medicine Parenteral nutrition medicine.anatomical_structure Bypass surgery Swallowing Esophagectomy 030220 oncology & carcinogenesis Medicine 030211 gastroenterology & hepatology Esophagus business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Swallowing corrosive substances leads to gastrointestinal stenosis due to scarification. • Bypass surgery was performed as adhesions posed risk of injury to adjacent organs. • Esophageal bypass with a “supercharged” pedicled jejunal flap was performed. • The technique creates anastomoses between jejunal and internal thoracic vessels. • It is an optimal technique for treatment of stenosis caused by corrosive esophagitis. Introduction Swallowing a corrosive substance causes delayed gastrointestinal stenosis due to scar formation. Here, we report on our use of esophageal bypass using a supercharged pedicled jejunal flap to treat cicatricial esophageal stenosis caused by corrosive esophagitis. Presentation of case Nineteen years before presentation, a 57-year-old man had swallowed a chemical cleaning agent, which caused extensive corrosive cicatricial stenosis from the thoracic upper esophagus to the gastric fornix. An enterostomy had been created, and the patient had since been subsisting on enteral nutrition. However, he wanted to be able to eat through his mouth again and was referred to our department for treatment. With the exception of the cervical esophagus, circumferential cicatricial stenosis was present throughout the esophagus and gastric fornix, with severe adhesions to the surrounding tissue. It was decided not to perform esophagectomy but to perform esophageal bypass surgery using a supercharged pedicled jejunal flap. Discussion Despite the extremely high risk of cancer in the stenotic esophagus due by corrosive esophagitis, indicating that esophagectomy should be performed if possible, we chose to perform bypass surgery because the severe adhesions posed a high risk of early injury to the surrounding organs. Conclusion We suggest that esophageal bypass using pedicled jejunal pull-up “supercharging” by creating anastomoses between the jejunal and internal thoracic vessels is the optimal procedure for patients with extensive cicatricial esophageal stenosis caused by corrosive esophagitis. |
| Databáze: | OpenAIRE |
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