Artículo de revista
Pharyngo-ileo-colo-anastomosis with microvascular blood supply augmentation for esophago-gastric replacement due to esophago-gastric necrosis after caustic ingestion
Fecha
2018Registro en:
ABCD Arq Bras Cir Dig 2018;31(2):e1381
0102-6720
10.1590/0102-672020180001e1381
Autor
Braghetto Miranda, Italo
Figueroa, Manuel
Sanhueza, Belén
Lanzarini Sobrevía, Enrique
Sepulveda, Sergio
Erazo, Christian
Institución
Resumen
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.