2017, Number 2
Laparoscopic management of esophageal stenosis secondary to caustic ingestion in an adult patient. Case report
Sainz HJC, Fong HA, Rojas DO, Contreras RVR
Full text
Language: Spanish
References: 6
Page: 89-93
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ABSTRACT
Introduction: Ingestion of corrosive substances in adults is uncommon and is usually due to suicidal attempts. Most patients have mild injuries and recover without any sequelae. However, they can lead to serious injury and even death. Acute complications are usually perforation, bleeding, and fistula; while the chronic ones are pharyngeal, esophageal, or gastric stenosis. Esophagectomy is necessary in patients with severe esophageal stricture and will only be performed urgently when they present perforation, mediastinitis or peritonitis data. Case report: A 54-year-old woman with a history of sodium hydroxide ingestion (EasyOFF®), ignoring acute management of the patient. She developed progressive dysphagia and finally abundant sialorrhea. She was submitted to four serial endoscopic dilatations, however, symptomatology persisted and surgical treatment was proposed. Laparoscopic trans-hiatal esophagectomy was performed with esophagogastric anastomosis. The abdominal approach was performed using five trocars, the esophagus was dissected circumferentially in an ascending manner, simultaneously was performed an open cervical approach by a second surgical team, then performed gastric tubular gastroplasty using endoscopic stapler and then was ascended. Complete reconstruction by esophagogastric mechanical latero-lateral anastomosis, an omental patch was placed. On the fifth postoperative day, a contrast study was performed and oral intake was initiated afterward. She was discharged without complications on the ninth day of surgery. Conclusions: The trans-hiatal laparoscopic approach has proven to be safe and successful, however, there are only a few centers in our country where this approach is performed.REFERENCES