IS Case 236: Colonic interposition
Imaging Sciences URMC 2008
Publication Date: 2009-05-26
History
Patient is a 34-year-old male presenting with colonic interposition for esophageal atresia and tracheoesophageal (TE) fistula in infancy. He has had multiple small bowel resections and has a history of ulcers and worsening sensation of reflux.
Findings
Colonic interposition in the location of the esophagus.
Diagnosis
Discussion
Management of long gap esophageal atresia is a subject of ongoing controversy. Direct anastomosis is the preferred method of repair, but when this is not possible, esophageal replacement is performed. Colonic interposition is one of the more common techniques used. This is commonly associated with reflux and gastrocolic ulceration. Due to the severity of reflux, these patients can also develop recurrent pulmonary infections and pulmonary function impairment.
Due to a history of ulceration and severe reflux, this patient was undergoing evaluation for revision of the interposition.
References
- Séguier-Lipszyc E, Bonnard A, Aizenfisz S, Enezian G, Maintenant J, Aigrain Y, de Lagausie P. The management of long gap esophageal atresia. J Pediatr Surg. 2005 Oct;40(10):1542-6. [PMID: 16226981]
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