A Case of Reconstructive Gastric Tube Necrosis 6 months after Esophagectomy

Shinsuke Sasada, Jun Hihara, Hirozumi Mizuiri, Hideaki Ueno, Yoshiharu Kawabuchi, Yoichi Hamai, Manabu Emi, Kazuhiro Yoshida and Yoshiyuki Yamaguchi

Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University

We report a case of reconstructive gastric tube necrosis 6 months after subtotal esophagectomy. A 62-year-old man underwent posterior mediastinal reconstruction with half a gastric tube following subtotal esophagectomy and partial gastrectomy for advanced thoracic esophageal cancer and early gastric cancer. Postoperative chemoradiotherapy was added for residual cancer on the aortic wall. Six months after surgery, he was admitted for fever and general fatigue. Computed tomography and gastrointestinal endoscopy showed a reconstructive gastric tube ulcer.This was complicated during conservative therapy by a gastric tube tracheal. Despite mediastinal drainage, partial gastric tube resection, pericardium patch for the tracheal fistula and esophagostomy, he died due to multiple organ failure. The possibility of reconstructive gastric tube necrosis should thus be considered in symptoms associated with mediastinitis even several months after esophagectomy.

Key words
esophageal cancer, reconstructive gastric tube necrosis, gastric tube-tracheal fistula

Reprint requests
Shinsuke Sasada Department of Surgery and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563 JAPAN

Accepted
February 28, 2007

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