UNUSUAL COMPLICATION OF COLONIC INTERPOSITION FOR ESOPHAGEAL REPLACEMENT

A case of delayed fibrosis of the interposed left colon on a 65 year old man after an operation for peptic oesophageal stricture is reported. The development of the stricture was probably related to the acute hypotensive, hypoxic episode that occurred in the early postoperative period. The gastrografin swallow at five days shows some 'thumbprinting' of the interposed colon characteristic of ischaemic colitis. In view of the importance of the vascular supply to the interposed colon stable perfusion pressure and oxygenation must be maintained, particularly in the early postoperative period. Therefore it is recommended to use mechanical ventilation for a short period immediately after the operation in all cases of oesophageal replacement using interposed colon.