Perforation of a substernal interposed ileocolon caused by right thoracic herniation.
Perforation of a retrosternal interposed ileocolon is rare. We present a case of perforation of the interposed colon on the ninth postoperative day, which subsequently herniated to the right pleural space. We suggest that the dilated haustral trapping and the associated "waterfall" effect may have resulted in incarceration of the colon. Careful dissection of the pleura in order to create a retrosternal tunnel, and the use of a suitable length of an esophageal substitute could prevent this complication.
Department of Surgery, Taipei County Hospital, 5 Floor, No.17, Lane 12, Qing Tian Street, Taipei 106, Taiwan. kokvakei@ms29.hinet.net
Va-Kei
VK
Kok
D000714:Anastomosis, Surgical / Q000009:adverse effects; D003106:Colon / Q000601:surgery*; D004108:Dilatation, Pathologic; D016724:Empyema, Pleural / Q000209:etiology; D004944:Esophagoplasty / Q000009:adverse effects*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005260:Female; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006872:Hydropneumothorax / Q000209:etiology; D007082:Ileum / Q000601:surgery*; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D010994:Pleura / Q000601:surgery; D011859:Radiography; D013249:Sternum / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome