• Journal of Chest Surgery
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• v.29 no.4
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• pp.466-471
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• 1996

Esophageal atresia with tracheoesophageal fistula is a common form of congenital malformation of the esophagus, which was usually overlooked during the physical examination after delivery. The first report of esophageal atresia with tracheoesophageal fistula was done by Thomas-Gibson in 1696. We have performed primary repair by extrapleural approach through the right 4th intercostal space in 4 cases of congenital esophageal atresia with distal racheoesophageal fistula. End to end anastomosis was performed by Haight method in all cases. Postoperatively, two patients showed severe stenosis and one patient showed mild stenosis at the anastomotic site. Ballots dilatation was performed two cases with severe anastomotic stenosis.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.278-282
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• 2012

An esophageal perforation following anterior cervical fusion is rare. Early development of an esophageal perforation after anterior cervical fusion is usually due to iatrogenic injury from retraction, injury associated with the original traumatic incident, improperly placed instruments or a bone graft. A 31-year-old man had a cervical dislocation and spinal cord injury because of severe cervical trauma after a traffic accident. He was quadriplegic and had no feeling below T4 dermatome. Anterior decompression of the cervical spine and anterior fusion with mesh with autobone were performed. An esophagocutaneous fistula occurred 7 days after anterior cervical surgery. A second anterior surgery was done because of pus drainage. The mesh was changed with an iliac bone graft, and the esophagocutaneous fistula site was primary repaired, but pus continued to drain. Conservative treatment, which consisted of wound drainage and intravenous administration of antibiotics, was tried, but was unsuccessful. After all, we removed the plate and screws, but did not removed the iliac bone graft, We closed the esophageal fistula, and transposed the sternocleidomastoid muscle flap to the interspace between the esophagus and the cervical spine. The wound to the esophagus was well repaired. In conclusion, precautionary measures are needed to avoid the complication, and adequate treatment is necessary to resolve those complications when they occur.

• Journal of Chest Surgery
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• v.35 no.6
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• pp.479-482
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• 2002

Aortoesophageal fistula induced by endoesophageal stent is rare; however, it is usually a fatal disorder, with few survivors reported. We report a case of a 32-year old female with aortoesophageal fistula after insertion of the esophageal stent in esophageal lye stricture who was successfully diagnosed with endoscopy and treated in a two-stage operation. In the first stage, we performed esophagectomy, primary repair of the fistula site in the descending thoracic aorta, and feeding gastrostomy. After the patient recovered well postoperatively, a retrosternal interposition of the right colon and cervical esophago-colo-grastostomy were performed, to re-establish the gastrointestinal tract.

• Journal of Chest Surgery
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• v.26 no.4
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• pp.325-328
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• 1993

The pedicled omental flap has been used for treatment of various kind of complications in thoraxcic surgery. Its property of promoting neovascularization , immunilogic properties that limiting the spread of infection, providing soft tissue coverage are very effective in treatment esophageal fistulas. Also, congenital broncho-esophageal fistula [ BEF ] is a rare disease entity which was reported about 100 cases around the world. We experienced 27 years old female patient with Braimbridge type I congenital BEF. We performed division of BEF using stapler and pericardial patch coverage of esophageal side with concomittent left lower lobectomy. This patient was complicated with postoperative esophageal leakage with empyema thoracis. We have successfully managed these problems with re-thoracotomy and re-closure of esophageal fistula using Right Gastroepiploic Artery based pedicled omental flap wrapping around the esophageal anastomosis site. It is felt that pedicled omental flap is a very effective method to manage esophageal complication such as postoperative esophageal leakage.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.254-259
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• 2017

Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia- disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

• Advances in pediatric surgery
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• v.2 no.1
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• pp.68-71
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• 1996

Esophageal atresia(EA) with a double tracheoesophageal fistula(TEF) is rare. It accounts for only 0.7% of all cases of EA and TEF. A male newborn weighing 2860g was born by normal vaginal delivery at 41 weeks' gestation to a 27-year-old mother who had a normal pregnancy. But immediately developed recurrent choking and respiratory distress. Feeding tube was inserted and chest X ray showed the feeding tube coiled in the proximal pouch(T-2 level). With a preoperative diagnosis of EA and distal TEF, the thoracotomy was performed on the third day of life. At thoracotomy, TEF was proved to be a double fistula. Both fistulas were divided and an esophageal anastomosis was performed. The postoperative course was uncomplicated until the eighth postoperative day when a minor anastomotic leak. The patient was discharged at 103 days of age.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.565-569
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• 1987

The first description of the pathologic anatomy of esophageal atresia was presented by Duration in 1670, it was not successfully treated until 1939 when the first two survivors of staged correction were described by Ladd and Levin. In 1941 Haight and Towsley performed the first successful primary repair. Recently we were experienced a case of esophageal atresia with tracheoesophageal fistula an infant patient who presented the symptoms of vomiting and dyspnea. The diagnosis was made by the esophagography with Diagnosis. The operation was performed extrapleurally through 4th intercostal space after gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought into apposition with the presenting surface of the lower esophageal segment and an end to side anastomosis was fashioned with a single layer of sutures. Operative patient tolerated all the operative procedure well in spite of postoperative respiratory complication and recovered uneventfully, permitted feeding on 9th postoperative day after esophagography.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.127-130
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• 1983

Esophageal atresia and Tracheoesophageal fistula may occur as separate entities but usually occur in combination. First described by Durston in 1970, esophageal atresia was not successfully treated until 1939 when the first two survivors of staged correction were described by Ladd and Leven. In 1941, Haight and Towsley performed the first successful primary repair. Authors report four cases of esophageal atresia of which two cases were treated surgically in success with Haight`s method. The type of four cases were all the same as upper blind pouch and lower tracheoesphageal fistula. Two of them were associated with verterbral defect, imperforate anus and/or rib fusion. Two cases died within seven days due to parent`s refusal for operative therapy, others were treated surgically with Haight`s method. Operative patients tolerated all the operative procedure and recovered uneventfully, permitted feeding on 7th postoperative day. On follow up study, one patient revealed intermittent regurgitation and corrected with bougienation another with good health without complication.

• Journal of Chest Surgery
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• v.5 no.1
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• pp.45-56
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• 1972

Esophageal perforation is one of the most grave prognostic problems among thoracic and general surgical emergencies which necessitate urgent operative measures. In Korea,there are still many persons ingesting lye for suicidal attempt and thoracic surgeons in Korea have more chances to deal with lye burned esophagus with or without instrumental perforation than those in Western countries. Main cause of esophageal perforation in Korea is instrumental perforation in patients with lye stricture of the esophagus during diagnostic endoscopy or therapeutic bouginage. Other causes are corrosion of the esophagus due to ingestion of caustic agents, pathologic perforation, surgical trauma, stab wound and spontaneous rupture of the esophagus in our series. Therapeutic measures are various,and depend on duration of perforation, severity of its complications, pathology of perforated portion of the esophagus and degrees of inflammation at the point of perforation. The most important therapeutic measures are prevention of this grave condition during esophagoscopy, bouginage and surgical procedures on lungs and mediastinal structures and to make early diagnosis with prompt therapeutic measures. During the period of January, 1959, to December, 1971, the authors experienced 65 cases ofesophageal perforation including acquired esophagorespiratory fistula at Dept. of Chest Surgery, the National Medical Center in Seoul, and obtained following results in the series. 1. Female were 35 cases, and peak age incidence was 2nd and 3rd decades of life. 2. Among 65 cases, 43 were corrosive esophagitis or benign stricture of the esophagus due to caustic agents, 7 were patients with esophageal cancer. and there were 5 cases of esophageal perforation developed after pneumonectomy or pleuropneumonectomy. 3. Causes of perforation are instrumental perforation in 45, acute corrosion in 7, pathologic perforation in 7, surgical trauma in 3, stab wound in 2 cases, and one spontaneous rupture of the esophagus. 4. Most frequent sites of esophageal perforation were upper and mid thoracic esophagus, and 8 were cases with cervical esophageal perforation. 5. Complications of esophageal perforation were mediastinitis in 42, empyema or pneumothorax in 35, esophagorespiratory fistula in 12, retroperitoneal fistula or abscess in 5,pneumoperitoneum in 3, and localized peritonitis in 1 case. 6. Cases with malignant esophagorespiratory fistula were only 3 in the series which is predominant cause of acquired esophagorespiratory fistula in Western countries. 7. Various therapeutic measures were applied with mortality rate of 27.7% in the series. 8. In usual cases early treatment gave better prognosis, and least mortality rate in cases with perforation in mid thoracic esophagus. 9. Main causes of death were respiratory complications,acute hemorrhage with asphyxia, and septic complications. 10. Esophageal perforation developed after pneumonectomy gave more difficult therapeutic problems which were solved in only 1 among 5 cases.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1432-1435
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• 1992

Congenital bronchoesophageal fistula without esophageal atresia is very rare and often has an insidious clinical course that occaisionally persists into adult life. A 54-year-old female patient presented at our emergency room with a complaint of hemoptysis and dyspnea. Esophagogram revealed a fistula tract between mid-low esophagus and right superior segmental brochus of lower lobe. Fistulectomy was performed without problem. The postoperative course was uneventful.