JACK FISHER, M.D. Mayo Clinic Proceedings

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Presentation transcript:

Salvage of a Failed Colon Interposition in the Esophagus With a Free Jejunal Graft JACK FISHER, M.D. Mayo Clinic Proceedings Volume 59, Issue 3, Pages 197-201 (March 1984) DOI: 10.1016/S0025-6196(12)60773-3 Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Roentgenogram of gastroesophageal area after retrograde injection of contrast medium via the gastrostomy tube. Note filling of interposed substernal colon to a point 5 cm below clavicular heads. Mayo Clinic Proceedings 1984 59, 197-201DOI: (10.1016/S0025-6196(12)60773-3) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 Barium swallow roentgenogram, showing stricture of hypopharynx and cervical portion of esophagus. Arrowhead points to a cervical cutaneous fistula. Mayo Clinic Proceedings 1984 59, 197-201DOI: (10.1016/S0025-6196(12)60773-3) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 Photograph of 22-cm segment of jejunum isolated on its vascular pedicle before transfer. Mayo Clinic Proceedings 1984 59, 197-201DOI: (10.1016/S0025-6196(12)60773-3) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 4 Jejunal segment has been transferred to head and neck area, and proximal bowel anastomosis has been completed. Arrows denote remnant of substernal colon. Mayo Clinic Proceedings 1984 59, 197-201DOI: (10.1016/S0025-6196(12)60773-3) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 5 Proximal and distal bowel anastomoses have been completed, and segment of jejunum has been revascularized. Mayo Clinic Proceedings 1984 59, 197-201DOI: (10.1016/S0025-6196(12)60773-3) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 6 Diagram showing reconstruction of hypopharynx and esophagus with a free jejunal segment anastomosed to previous colon interposition. Mayo Clinic Proceedings 1984 59, 197-201DOI: (10.1016/S0025-6196(12)60773-3) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 7 Barium swallow roentgenograms 1½ years after reconstruction with free jejunal transplant. Black arrows denote proximal jejunal anastomosis to hypopharynx; white arrowheads identify distal jejunal anastomosis to colon. Mayo Clinic Proceedings 1984 59, 197-201DOI: (10.1016/S0025-6196(12)60773-3) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 8 Barium swallow roentgenogram, showing remnant of colon interposition with flow into stomach. Mayo Clinic Proceedings 1984 59, 197-201DOI: (10.1016/S0025-6196(12)60773-3) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions