Colonic interposition for Esophageal Substitution

Video Endoscopic Sequence 1 of 14.

Colonic interposition for Esophageal Substitution

Esophageal stenosis caused by caustic soda

This 18 year-old male, at the edged of 3 suffered of esophageal burn caused by accidental swallowing of caustic soda having a caustic injury

At the edged of 4 underwent of colonic interposition for esophageal substitution, (substitution of esophagus with vascularized colon) 1 month after the surgery a severe stenosis of the cervical junction appears, since that time the patient remain with a Foley's catheter used as Percutaneous gastrostomy.

At the edged of 18 a new surgery to overcome the stenosis was performed, but the stenosis re-appears one month after.

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Colonic interposition for Esophageal Substitution

Video Endoscopic Sequence 2 of 14.

A hydrostatic balloon has been used to perform dilation.

Caustic substances (strong acids and alkalies), when swallowed, can burn the tongue, mouth, esophagus, and stomach. These burns may cause perforation (piercing) of the esophagus or stomach.

Food and saliva leaking from a perforation cause severe, sometimes deadly infection within the chest (mediastinitis or empyema) or abdomen (peritonitis). Burns that do not perforate can result in scarring of the esophagus and stomach.

Video Endoscopic Sequence 3 of 14.

After the stenosis has been overcome with the dilation, a view of the Colonic interposition is seen.

Industrial products are usually the most damaging because they are highly concentrated. However, some common household products, including drain and toilet bowl cleaners and some dishwasher detergents, contain damaging caustic substances, such as sodium hydroxide and sulfuric acid.

Because caustic substances can cause as much damage returning up the esophagus as they did when swallowed, a person who has swallowed a caustic substance should not be made to vomit.

Video Endoscopic Sequence 4 of 14.

The Gastric Colonic Anastomosis.

The diameter appear to be diminished.

Video Endoscopic Sequence 5 of 14.

This view represent the scar where the esophagus was excluded.

Video Endoscopic Sequence 6 of 14.

Video Endoscopic Sequence 7 of 14.

Video Endoscopic Sequence 8 of 14.

Video Endoscopic Sequence 9 of 14.

Video Endoscopic Sequence 10 of 14.

Colonic view

Video Endoscopic Sequence 11 of 14.

A retroflexed view inside the colon from the gastric colonic junction to the upper cervical part is observed, in the video clip you can see the fibrosis where the previous stenosis that was dilated.

Video Endoscopic Sequence 12 of 14.

X-ray Film

 X-ray Film. Colonic interposition is observed there is a
 stenosis part of the upper portion.

Video Endoscopic Sequence 13 of 14.

X-Ray Film

Distorted and healed anatomy.

Video Endoscopic Sequence 14 of 14.

X-ray Film

A scar diverticula is seen.

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