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Gastric Conduit Perforation: A Late Fatal Complication after Esophagectomy

With an increasing number of long-term survivors of carcinoma esophagus, it is important to be vigilant about postoperative complications related to gastric tubes. Perforation of the gastric conduit has been rarely seen, with very few case reports in the literature. We report a rare case of perforat...

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Autores principales: Kulkarni, Aditya A, Chauhan, Vivek, Sharma, Vishal, Singh, Harjeet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707818/
https://www.ncbi.nlm.nih.gov/pubmed/31497418
http://dx.doi.org/10.7759/cureus.4987
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author Kulkarni, Aditya A
Chauhan, Vivek
Sharma, Vishal
Singh, Harjeet
author_facet Kulkarni, Aditya A
Chauhan, Vivek
Sharma, Vishal
Singh, Harjeet
author_sort Kulkarni, Aditya A
collection PubMed
description With an increasing number of long-term survivors of carcinoma esophagus, it is important to be vigilant about postoperative complications related to gastric tubes. Perforation of the gastric conduit has been rarely seen, with very few case reports in the literature. We report a rare case of perforation of the gastric tube conduit in a patient who had previously undergone esophagectomy for squamous cell carcinoma of esophagus five years ago. The patient presented with diffuse peritonitis in an emergency. On exploration, a large perforation was present on the anterior wall of the gastric conduit. This was closed with primary suture repair. Histopathology revealed nonspecific inflammatory changes. Unfortunately, the patient succumbed to severe sepsis and multiorgan dysfunction despite early surgical intervention and critical care management. Conduit perforation can be a major source of morbidity and mortality. Although gastric conduit is predisposed to ulcer formation due to multiple reasons, conduit perforation may occur only in rare cases. We recommend that surveillance endoscopy for conduit ulcer should be performed in long-term survivors after esophagectomy. Patients with conduit ulcers would benefit from long-term acid suppression with proton-pump inhibitors.
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spelling pubmed-67078182019-09-06 Gastric Conduit Perforation: A Late Fatal Complication after Esophagectomy Kulkarni, Aditya A Chauhan, Vivek Sharma, Vishal Singh, Harjeet Cureus Gastroenterology With an increasing number of long-term survivors of carcinoma esophagus, it is important to be vigilant about postoperative complications related to gastric tubes. Perforation of the gastric conduit has been rarely seen, with very few case reports in the literature. We report a rare case of perforation of the gastric tube conduit in a patient who had previously undergone esophagectomy for squamous cell carcinoma of esophagus five years ago. The patient presented with diffuse peritonitis in an emergency. On exploration, a large perforation was present on the anterior wall of the gastric conduit. This was closed with primary suture repair. Histopathology revealed nonspecific inflammatory changes. Unfortunately, the patient succumbed to severe sepsis and multiorgan dysfunction despite early surgical intervention and critical care management. Conduit perforation can be a major source of morbidity and mortality. Although gastric conduit is predisposed to ulcer formation due to multiple reasons, conduit perforation may occur only in rare cases. We recommend that surveillance endoscopy for conduit ulcer should be performed in long-term survivors after esophagectomy. Patients with conduit ulcers would benefit from long-term acid suppression with proton-pump inhibitors. Cureus 2019-06-24 /pmc/articles/PMC6707818/ /pubmed/31497418 http://dx.doi.org/10.7759/cureus.4987 Text en Copyright © 2019, Kulkarni et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Gastroenterology
Kulkarni, Aditya A
Chauhan, Vivek
Sharma, Vishal
Singh, Harjeet
Gastric Conduit Perforation: A Late Fatal Complication after Esophagectomy
title Gastric Conduit Perforation: A Late Fatal Complication after Esophagectomy
title_full Gastric Conduit Perforation: A Late Fatal Complication after Esophagectomy
title_fullStr Gastric Conduit Perforation: A Late Fatal Complication after Esophagectomy
title_full_unstemmed Gastric Conduit Perforation: A Late Fatal Complication after Esophagectomy
title_short Gastric Conduit Perforation: A Late Fatal Complication after Esophagectomy
title_sort gastric conduit perforation: a late fatal complication after esophagectomy
topic Gastroenterology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707818/
https://www.ncbi.nlm.nih.gov/pubmed/31497418
http://dx.doi.org/10.7759/cureus.4987
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