Radical esophagectomy for a patient with reversed intestinal rotation and complicated vascular anomalies in the abdomen.
We report a patient of lower esophageal carcinoma with reversed intestinal rotation and major vascular anomalies including pre-duodenal pre-pancreatic portal vein, absence of the confluence of the splenic vein with the superior mesenteric vein, and deficiency of the common hepatic artery. We performed subtotal esophagectomy with three-field lymphadenectomy following reconstruction with the stomach. The postoperative course was uneventful. This might be the first case that had such complicated anatomical anomalies and radical esophagectomy was performed. As we had preoperatively recognized these anatomical anomalies on radiographic examinations, we could successfully perform esophagectomy and reconstruction without any complications.
Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan. i.makino@staff.kanazawa-u.ac.jp
Isamu
I
Makino
Itasu
I
Ninomiya
Takashi
T
Fujimura
Jun
J
Kinoshita
Keishi
K
Nakamura
Katsunobu
K
Oyama
Hideto
H
Fujita
Sachio
S
Fushida
Masato
M
Kayahara
Tetsuo
T
Ohta
D000792:Angiography; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000002:abnormalities*; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000002:abnormalities*; D008875:Middle Aged; D013162:Splenic Vein / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed; D054079:Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging