Managing esophagocutaneous fistula after secondary gastric pullup:A case report  

作　　者：Johan F Lock Stanislaus Reimer Sebastian Pietryga Rafael Jakubietz Sven Flemming Alexander Meining Christoph-Thomas Germer Florian Seyfried 

机构地区：[1]Department of General,Visceral,Transplantation,Vascular and Pediatric Surgery,University Hospital Würzburg,Würzburg 97080,Germany [2]Department of Gastroenterology,University Hospital Würzburg,Würzburg 97080,Germany [3]Department of Trauma-,Hand-,Plastic-and Reconstructive Surgery,University Hospital Würzburg,Würzburg 97080,Germany

出　　处：《World Journal of Gastroenterology》2021年第16期1841-1846,共6页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Gastric pull-up(GPU)procedures may be complicated by leaks,fistulas,or stenoses.These complications are usually managed by endoscopy,but in extreme cases multidisciplinary management including reoperation may be necessary.Here,we report a combined endoscopic and surgical approach to manage a failed secondary GPU procedure.CASE SUMMARY A 70-year-old male with treatment-refractory cervical esophagocutaneous fistula with stenotic remnant esophagus after secondary GPU was transferred to our tertiary hospital.Local and systemic infection originating from the infected fistula was resolved by endoscopy.Hence,elective esophageal reconstruction with freejejunal interposition was performed with no subsequent adverse events.CONCLUSION A multidisciplinary approach involving interventional endoscopists and surgeons successfully managed severe complications arising from a cervical esophagocutaneous fistula after GPU.Endoscopic treatment may have lowered the perioperative risk to promote primary wound healing after free-jejunal graft interposition.

关 键 词：Esophageal fistula Gastric fistula Esophageal stenosis Esophageal perforation Endoscopic vacuum therapy Free-jejunal graft Autogenous jejunum transplantation Case report 

分 类 号：R655.4[医药卫生—外科学]