Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Non-Surgical Management of Critically Compromised Airway Due to Dilatation of Interposed Colon

  • Min, Jinsoo (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Cho, Young-Jae (Department of Internal Medicine, Seoul National University Bundang Hospital)
  • Received : 2015.05.25
  • Accepted : 2015.11.03
  • Published : 2016.03.31
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Abstract

We present a rare case of critically compromised airway secondary to a massively dilated sequestered colon conduit after several revision surgeries. A 71-year-old male patient had several operations after the diagnosis of gastric cancer. After initial treatment of pneumonia in the pulmonology department, he was transferred to the surgery department for feeding jejunostomy because of recurrent aspiration. However, he had respiratory failure requiring mechanical ventilation. The chest computed tomography (CT) scan showed pneumonic consolidation at both lower lungs and massive dilatation of the substernal interposed colon compressing the trachea. The dilated interposed colon was originated from the right colon, which was sequestered after the recent esophageal reconstruction with left colon interposition resulting blind pouch at both ends. It was treated with CT-guided pigtail catheter drainage via right supraclavicular route, which was left in place for 2 weeks, and then removed. The patient remained well clinically, and was discharged home.

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References

  1. Furst H, Hartl WH, Lohe F, Schildberg FW. Colon interposition for esophageal replacement: an alternative technique based on the use of the right colon. Ann Surg 2000;231:173-8. https://doi.org/10.1097/00000658-200002000-00004
  2. Schein M, Conlan AA, Hatchuel MD. Surgical management of the redundant transposed colon. Am J Surg 1990;160:529-30. https://doi.org/10.1016/S0002-9610(05)81021-9
  3. Jeyasingham K, Lerut T, Belsey RH. Functional and mechanical sequelae of colon interposition for benign oesophageal disease. Eur J Cardiothorac Surg 1999;15:327-31. https://doi.org/10.1016/S1010-7940(99)00007-X
  4. Thomas P, Fuentes P, Giudicelli R, Reboud E. Colon interposition for esophageal replacement: current indications and long-term function. Ann Thorac Surg 1997;64:757-64. https://doi.org/10.1016/S0003-4975(97)00678-4
  5. Collins KC, Odell DD, Sheiman RG, Gangadharan SP. Critically compromised airway secondary to expanding esophageal mucocele. Ann Thorac Surg 2012;94:635-6. https://doi.org/10.1016/j.athoracsur.2011.12.079
  6. Cheng YJ, Wang KH, Chen HC, Hsieh KC, Chang PC. Esophageal mucocele with compression of the right recurrent laryngeal nerve 20 years after surgical intervention for caustic esophagitis. Ann Thorac Surg 2010;90:e28-9. https://doi.org/10.1016/j.athoracsur.2010.05.020
  7. Khan BA, Halal AM, Kesler KA. Extrapericardial cardiac compression secondary to a massively dilated substernal colon conduit. Chest 2010;138:31A. https://doi.org/10.1378/chest.10159
  8. Ahmed A, Spitz L. The outcome of colonic replacement of the esophagus in children. Prog Pediatr Surg 1986;19:37-54.
  9. Kelly JP, Shackelford GD, Roper CL. Esophageal replacement with colon in children: functional results and long-term growth. Ann Thorac Surg 1983;36:634-43. https://doi.org/10.1016/S0003-4975(10)60272-X
  10. Bonavina L, Chella B, Segalin A, Luzzani S. Surgical treatment of the redundant interposed colon after retrosternal esophagoplasty. Ann Thorac Surg 1998;65:1446-8. https://doi.org/10.1016/S0003-4975(98)00162-3