Transverse colon perforation in the mediastinum after esophagectomy: a case report
Abstract Background While anastomotic leakage, recurrent laryngeal nerve paralysis, and pneumonia are well-known complications of esophagectomy, the incidence of hiatal hernia after esophagectomy for carcinoma has been reported to only be between 0.6 and 10%. We report a very rare case of hiatal her...
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| Format: | Article |
| Language: | English |
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Japan Surgical Society
2020-05-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-020-00862-5 |
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| author | Takuro Konno-Kumagai Tadashi Sakurai Yusuke Taniyama Chiaki Sato Kai Takaya Ken Ito Takashi Kamei |
| author_facet | Takuro Konno-Kumagai Tadashi Sakurai Yusuke Taniyama Chiaki Sato Kai Takaya Ken Ito Takashi Kamei |
| author_sort | Takuro Konno-Kumagai |
| collection | DOAJ |
| description | Abstract Background While anastomotic leakage, recurrent laryngeal nerve paralysis, and pneumonia are well-known complications of esophagectomy, the incidence of hiatal hernia after esophagectomy for carcinoma has been reported to only be between 0.6 and 10%. We report a very rare case of hiatal hernia with transverse colon rupture in the mediastinum after esophagectomy in a 65-year-old woman. Case presentation The patient underwent definitive chemoradiotherapy for clinical stage IIA esophageal squamous cell carcinoma and salvage esophagectomy with gastric tube reconstruction through a posterior mediastinum route for residual carcinoma. Three years after the initial surgery, two metastatic nodules in the lateral and posterior segments of the liver were detected on follow-up CT and were treated with oral anticancer drugs. After 6 months, the patient was readmitted for anorexia. Upon admission, computed tomography revealed an ileus caused by a hiatal hernia. Emergent operative repair was performed; an incarcerated herniation of the transverse colon was perforated in the mediastinum, and partial transverse colon resection and colostomy were performed. Intensive care was required to control septic shock after surgery, and the patient was discharged on the 53rd postoperative day. Conclusions Cases of hiatal hernia with digestive tract prolapsing into the mediastinum after esophagectomy with reconstruction through posterior mediastinum are rare but potentially life-threatening complications. |
| format | Article |
| id | doaj-art-e3c213fdfc90400cbb13c5049a939e64 |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2020-05-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-e3c213fdfc90400cbb13c5049a939e642025-08-20T02:50:56ZengJapan Surgical SocietySurgical Case Reports2198-77932020-05-01611610.1186/s40792-020-00862-5Transverse colon perforation in the mediastinum after esophagectomy: a case reportTakuro Konno-Kumagai0Tadashi Sakurai1Yusuke Taniyama2Chiaki Sato3Kai Takaya4Ken Ito5Takashi Kamei6Division of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuDivision of Advanced Surgical Science and Technology, Graduate School of Medicine, University of TohokuAbstract Background While anastomotic leakage, recurrent laryngeal nerve paralysis, and pneumonia are well-known complications of esophagectomy, the incidence of hiatal hernia after esophagectomy for carcinoma has been reported to only be between 0.6 and 10%. We report a very rare case of hiatal hernia with transverse colon rupture in the mediastinum after esophagectomy in a 65-year-old woman. Case presentation The patient underwent definitive chemoradiotherapy for clinical stage IIA esophageal squamous cell carcinoma and salvage esophagectomy with gastric tube reconstruction through a posterior mediastinum route for residual carcinoma. Three years after the initial surgery, two metastatic nodules in the lateral and posterior segments of the liver were detected on follow-up CT and were treated with oral anticancer drugs. After 6 months, the patient was readmitted for anorexia. Upon admission, computed tomography revealed an ileus caused by a hiatal hernia. Emergent operative repair was performed; an incarcerated herniation of the transverse colon was perforated in the mediastinum, and partial transverse colon resection and colostomy were performed. Intensive care was required to control septic shock after surgery, and the patient was discharged on the 53rd postoperative day. Conclusions Cases of hiatal hernia with digestive tract prolapsing into the mediastinum after esophagectomy with reconstruction through posterior mediastinum are rare but potentially life-threatening complications.http://link.springer.com/article/10.1186/s40792-020-00862-5Hiatal herniaPost-esophagectomyPerforated colonSeptic shock |
| spellingShingle | Takuro Konno-Kumagai Tadashi Sakurai Yusuke Taniyama Chiaki Sato Kai Takaya Ken Ito Takashi Kamei Transverse colon perforation in the mediastinum after esophagectomy: a case report Surgical Case Reports Hiatal hernia Post-esophagectomy Perforated colon Septic shock |
| title | Transverse colon perforation in the mediastinum after esophagectomy: a case report |
| title_full | Transverse colon perforation in the mediastinum after esophagectomy: a case report |
| title_fullStr | Transverse colon perforation in the mediastinum after esophagectomy: a case report |
| title_full_unstemmed | Transverse colon perforation in the mediastinum after esophagectomy: a case report |
| title_short | Transverse colon perforation in the mediastinum after esophagectomy: a case report |
| title_sort | transverse colon perforation in the mediastinum after esophagectomy a case report |
| topic | Hiatal hernia Post-esophagectomy Perforated colon Septic shock |
| url | http://link.springer.com/article/10.1186/s40792-020-00862-5 |
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