Abstract
A 61-year-old man was brought into our hospital by ambulance from another hospital because of dysphagia and hypoxemia. A chest CT scan showed an irregular-shaped aneurysm of the thoracic descending aorta which had oppressed the left bronchus and esophagus. The patient was admitted with a diagnosis of infectious aortic aneurysm, and on the next day he underwent endovascular stent grafting to repair the descending aortic aneurysm. Endoscopy conducted on the second postoperative day revealed ischemic change in the esophagus, but no leakage of contrast medium was demonstrated by esophagography. A CT scan on the 7th postoperative day revealed extraesophageal gas image at the mediastinum. Esophagography also confirmed leakage of contrast medium into the mediastinum. Esophageal perforation was thus diagnosed and esophagectomy was performed by right thoracotomy on the 8th postoperative day. The resected esophagus revealed necrotic defluxion of the wall extending through the full thickness of the esophagus. Esophageal reconstruction was done on the 49th day after the esophagectomy. The esophageal reconstruction was made by anastomosing the total gastric tube to the remnant esophagus via ante-sternal route.
