Omental flap for mediastinitis after median sternotomy in asplenia syndrome and gut malrotation.
We describe a 12-year-old patient with asplenia syndrome and gut malrotation who, after an interim step before a modified Fontan operation, developed life-threatening mediastinitis. A flap of the omentum arising from the transverse colon, longitudinally located in the left of the abdomen, was created and transferred to the mediastinum after a division of the arterial arcade at its most caudal extent. Her postoperative course was uneventful, and 12 months later, the modified Fontan operation was successfully completed. Although visceral heterotaxy results in an omental deformation, it does not preclude the use of an omental flap.
Aeba
R
R
Division of Cardiovascular Surgery, Keio University, Tokyo, Japan. aeba@mc.med.keio.ac.jp
Katogi
T
T
Moro
K
K
Kawada
S
S
D000015:Abnormalities, Multiple / Q000601:surgery*; D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002648:Child; D003914:Dextrocardia / Q000150:complications / Q000601:surgery*; D004310:Double Outlet Right Ventricle / Q000150:complications / Q000601:surgery*; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006801:Humans; D007422:Intestines / Q000002:abnormalities*; D008480:Mediastinitis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery*; D009852:Omentum / Q000637:transplantation*; D011666:Pulmonary Valve Stenosis / Q000150:complications / Q000601:surgery*; D013154:Spleen / Q000002:abnormalities*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D013577:Syndrome
D000900:Anti-Bacterial Agents