Abstract
This case involved a 66-year-old man who underwent esophagectomy by right thoracotomy and retrosternal gastric conduit reconstruction of the esophagus for esophageal cancer 9 years earlier. About 2 months prior to the current visit, he noticed coughing and phlegm. His cough temporarily abated, but he developed difficulty in breathing, so he was seen at a nearby physician. Heart failure was suspected, and he was referred to the Department of Internal Medicine in our hospital. Further tests and exams suggested perforation caused by an ulcer in the gastric conduit. The patient was referred to our department and underwent emergency surgery. “Median laparotomy and median sternotomy disclosed large quantities of necrotic tissue around the gastric conduit and an ulcer in the posterior wall of the gastric conduit. The pericardium was perforated due to the ulcer. The gastric conduit was dissected from the pericardium and removed, and an cervical esophageal stoma was created. On the postoperative day 111, two-stage esophageal reconstruction was performed using jejunal Roux-en Y reconstruction and additional vascular anastomosis via the anterior chest wall. His postoperative course was satisfactory, and he was discharged on the 21st day after the reconstruction. Since few reports of such cases have been described, the present case is reported.
