Catastrophic complications of the cervical esophagogastric anastomosis

Slides:

Advertisements

Similar presentations

Bypass graft to the contralateral internal jugular vein for venous outflow obstruction of a functioning hemodialysis access fistula Jeff L. Myers, MD,

Advertisements

A.Marc Gillinov, MD, Gosta Pettersson, MD, Thomas W. Rice, MD

Kommerell diverticulum, right-sided aorta, and left aberrant subclavian artery in a patient with dysphagia Jenn-Yu Wu, MD, Hsin-Yi Chen, MD, Chin-Chung.

Pleural Partition With Intrathoracic Muscle Transposition (Muscle Tent) To Manage Residual Spaces After Subtotal Pulmonary Resections Gaetano Rocco,

Pulmonary Lobectomy in a Patient With a Left Ventricular Assist Device

Acute blunt traumatic injury to the descending thoracic aorta

Spontaneous Perforation of the Esophagus in a Patient With Achalasia

Diagnosis and management of aortoesophageal fistula caused by a foreign body Giuseppe S Sica, MD, PhD, Veronica Djapardy, MD, Stephen Westaby, MD, PhD,

A giant thoracic duct cyst: An unusual cause of dysphagia

Massive hiatus hernia: Evaluation and surgical management

Michael G. Scheidler, MD, Robert J. Keenan, MD, Richard H

Transesophageal biopsy of mediastinal and pulmonary tumors by means of endoscopic ultrasound guidance Michael Hünerbein, MD, Bijan Michael Ghadimi, MD,

Prevalence and location of nodal metastases in distal esophageal adenocarcinoma confined to the wall: Implications for therapy John J. Nigro, MD, Jeffrey.

Transhiatal gastrobronchial fistula: A case report

Ian Adatia, FRCP(C), Andrew M. Atz, MD, Richard A. Jonas, MD, David L

Thrombus in the left superior pulmonary vein after left upper pulmonary lobectomy Eiki Nagaoka, MD, Makoto Yano, PhD, Takahiko Sugano, MD, Takamichi Miyamoto,

Closure with bronchial wall flap and omental pedicle of defect caused by dehiscence of tracheal suture line after extended right upper sleeve lobectomy

Paul M. Kirshbom, MD, James J. Jaggers, MD, Ross M. Ungerleider, MD

A Rare Case of Partial Anomalous Pulmonary Venous Return to Azygos Vein Without Direct Connection to Great Cardiac Vessels Jae Gun Kwak, MD, Soo-Jin.

Median sternotomy for pneumonectomy in patients with pulmonary complications of tuberculosis Cliff P Connery, MD, James Knoetgen, MD, Constantine E Anagnostopoulos,

Pranya Sakiyalak, MD, Wickii T Vigneswaran, MD

Elliot L. Servais, MD, Brendon M. Stiles, MD, Jason A

Pulmonary artery–bronchial fistula during lymphoma treatment

Anthony W. Kim, MD, Robert J. Korst, MD, Jeffrey L. Port, MD, Nasser K

Recurrent infective endocarditis one year after mitral repair in a woman addicted to drugs Jean-Jacques Monsuez, MDa, Daniel Vittecoq, MDa, Christophe.

Robert J. Korst, MD, Michael E. Burt, MD, PhD

Surgical Repair of Long-Segment Cervical Esophageal Injury With a Sternocleidomastoid Myocutaneous Flap Juan A. Sanchez, MD, Lucian Panait, MD The Annals.

A stitch too far: The circumflex artery in jeopardy during mitral valve repair Jeswant Dillon, MD, FRCS The Journal of Thoracic and Cardiovascular Surgery

Richard F Heitmiller, MD, A.Marc Gillinov, MD, Bronwyn Jones, MD

Lemierre’s syndrome: A potentially fatal complication that may require vascular surgical intervention Kirk Charles, MD, William R. Flinn, MD, David G.

Acute chest pain and tamponading left hemothorax: An unusual presentation of pulmonary arteriovenous malformation Ira R.A. Goldsmith, MD, FRCS CTh, Ihab.

Gastric Rupture Associated With Diaphragmatic Hernia During Pregnancy

Bronchogenic cysts of the mediastinum

Benign expectoration of a surgical clip through a pneumonectomy stump

Foreign Body Retained in the Esophagus for More Than a Decade: Thoracic Esophagotomy for Retrieval Olusola Oduntan, MD, James Bardes, MD, Karthik Penumesta,

Transhiatal esophagectomy after previous right pneumonectomy

Lloyd M. Felmly, BS, Walter F. DeNino, MD, Chadrick E. Denlinger, MD

A.Marc Gillinov, MD, Gosta Pettersson, MD, Thomas W. Rice, MD

Lobar torsion after pulmonary resection: Presentation and outcome

Primary repair of rupture of a main and lobar bronchus

Support Your Specialty

Solitary coronary ostium and aberrant coursing left coronary arteries: Unfavorable anatomic anomaly in a case of aortic valve replacement M. Benedetti,

Successful thoracoscopic debridement of descending necrotizing mediastinitis Noritaka Isowa, MD, Tetsu Yamada, MD, Takeshi Kijima, DDS, Kazuki Hasegawa,

Postinfarction ventricular septal rupture: Repair by endocardial patch with infarct exclusion Tirone E. David, MD, Laura Dale, RN (by invitation), Zhao.

Juan A. Cordero, MD, Darroch W.O. Moores, MD

Surgical versus endovascular treatment of traumatic thoracic aortic rupture Philippe Amabile, MD, Frédéric Collart, MD, Vlad Gariboldi, MD, Gilles Rollet,

Staged Repair of Benign Tracheo-Neo-Esophageal Fistula 12 Years After Esophagectomy for Esophageal Cancer Charles Bakhos, MD, MS, Saleh Alazemi, MD,

Choice of second pericardial drainage tube for posterior placement

A case of chest wall angiosarcoma associated with breast implants

Mark K. Ferguson, MD, Amy E. Durkin, MS, PA-C

Aortic root thrombosis after transhiatal esophagectomy: A case report

Bypass graft to the contralateral internal jugular vein for venous outflow obstruction of a functioning hemodialysis access fistula Jeff L. Myers, MD,

The Common Trunk of the Left Pulmonary Vein Injured Incidentally During Lung Cancer Surgery Toru Nakamura, MD, Masaaki Koide, MD, Hidenori Nakamura,

Robert A. McCready, MD, Steven K. Miller, MD, Ronald C

Descending necrotizing mediastinitis: An analysis of the effects of serial surgical debridement on patient mortality Richard K. Freeman, MD, Eric Vallières,

Low-grade fibromyxoid sarcoma arising in the mediastinum

Shunt right or left? Decision 2016

Primary desmoid tumor of the posterior mediastinum

Primary aortoesophageal fistula from aortic aneurysm: Successful surgical treatment by use of omental pedicle graft Joseph S. Coselli, MD, E.Stanley.

P.K. Spanos, MD, A.D. Bisbos, MD, I.I. Arditis, MD

Kristin B. Miller, MD, Brian Kaplan, MD, Ray W. Shepherd, MD

Initial human evaluation of argon laser—assisted vascular anastomoses

Epidural abscess: a delayed complication of esophageal stenting for benign stricture Nicholas M Boulis, MD, Wendy S Armstrong, MD, William F Chandler,

Spontaneous closure of a large tracheal fistula due to descending necrotizing mediastinitis Hiroshi Kato, MD, Nobukazu Ohkubo, MD, Kenji Akazawa, MD,

Allergic bronchopulmonary aspergillosis with multiple Streptococcus pneumoniae lung abscesses: An unusual initial case presentation Kimberly K. Ricaurté,

Esophagectomy with gastric reconstruction for achalasia

Left subclavian artery aneurysm: Two cases of rare congenital etiology

FDG imaging of a pulmonary artery sarcoma

Invited commentary The Annals of Thoracic Surgery

Direct repair of giant right coronary aneurysm

Presentation transcript:

Catastrophic complications of the cervical esophagogastric anastomosis Mark D. Iannettoni, MD (by invitation), Richard I. Whyte, MD (by invitation), Mark B. Orringer, MD The Journal of Thoracic and Cardiovascular Surgery Volume 110, Issue 5, Pages 1493-1501 (November 1995) DOI: 10.1016/S0022-5223(95)70072-2 Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Barium esophagogram from patient with postoperative fever caused by CEGA disruption associated with gastric tip necrosis. Oblique projection demonstrates extravasation of contrast (arrow) into low posterior mediastinum alongside intrathoracic stomach, indicating major disruption. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 1493-1501DOI: (10.1016/S0022-5223(95)70072-2) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 2 Cervical magnetic resonance imaging scan of patient 3 who had quadriplegia and neck pain from epidural abscess (arrow) that necessitated operative debridement and drainage. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 1493-1501DOI: (10.1016/S0022-5223(95)70072-2) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Chest computed tomographic scan from patient 1 demonstrating multiple pulmonary abscesses as a result of intravascular dissemination from cervical abscess formed by wall of left internal jugular vein. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 1493-1501DOI: (10.1016/S0022-5223(95)70072-2) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 4 Contained anterior CEGA leak demonstrated on barium esophagogram 10 days after operation. Extravasated barium abutsposterior membranous trachea. This leak was asymptomatic and was notdrained. Nine days later, a tracheoesophagogastric anastomosis fistula developed and patient ultimately died of multisystem organ failure after attempted repair. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 1493-1501DOI: (10.1016/S0022-5223(95)70072-2) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 5 Currently advocated technique of suspension stitch placement. Two anterior sutures between back of cervical esophagus and adjacent stomach limit tension on esophagogastric anastomosis and prevent needle inoculation of spine, which is inherent in posterior sutures. (Reproduced with modification with permission from Orringer MB. Transhiatal esophagectomy without thoracotomy. In: Orringer MB, Zuidema GD, eds. Shackelford's surgery of the alimentary tract. 3rd ed. Vol. 1. Philadelphia: WB Saunders, 1991.) The Journal of Thoracic and Cardiovascular Surgery 1995 110, 1493-1501DOI: (10.1016/S0022-5223(95)70072-2) Copyright © 1995 Mosby, Inc. Terms and Conditions