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KMID : 0812020090150010070
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Korean Journal of Neurogastroenterology and Motility
2009 Volume.15 No. 1 p.70 ~ p.75
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Cervical Pseudodiverticulum and an Intra-thoracic Redundant Graft after Coloesophagoplasty for a Corrosive Injury
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Abstract
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Corrosive injury of the esophagus tends to occur more commonly due to intentional ingestion of corrosive substances, rather than due to accidents or as a complication of esophageal diseases. Long-term complications of esophageal corrosive injury include esophageal stricture, antral stenosis and rarely, the development of esophageal carcinoma. When esophageal stricture occurs, initial treatment is performed by repetitive bougie dilatation and balloon catheter dilation. However, in cases with severe esophageal stricture, esophageal dilatation is ineffective and esophageal reconstructive surgery is necessary. The colon is the most common organ used to substitute for the esophagus. An appropriate blood supply is crucial to maintain its function. The propulsive contraction, of the distal colon as a substitute, is an especially important force needed to propel a bolus into the stomach. However, a motility disturbance in this section may produce redundancy of the graft or a pseudodiverticulum at the proximal anastomosis site of the esophagoplasty, resulting in complications such as food retention. We treated a patient who presented with a cervical pseudodiverticulum and redundancy of the intra-thoracic colon graft three years after coloesophagoplasty. Revision surgery was performed to relieve the debilitating symptoms including dysphagia, nausea, vomiting, and severe weight loss. The surgery improved the patient’s quality of life. (Kor J Neurogastroenterol Motil 2009;15:70-75)
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KEYWORD
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Esophagoplasty, Pseudodiverticulum, Colon graft, Redundancy
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