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Subxiphoid pericardial drainage for gastric tube ulcer penetrating the pericardium after esophagectomy: A case report.
Ohno, Shinya; Tanaka, Yoshihiro; Sato, Yuta; Kato, Takayoshi; Doi, Kiyoshi; Matsuhashi, Nobuhisa.
Afiliación
  • Ohno S; Department of Gastroenterological Surgery, Pediatric Surgery, Gifu Graduate School of Medicine, Gifu, Japan.
  • Tanaka Y; Department of Gastroenterological Surgery, Pediatric Surgery, Gifu Graduate School of Medicine, Gifu, Japan. Electronic address: yoshihirotana11@hotmail.com.
  • Sato Y; Department of Gastroenterological Surgery, Pediatric Surgery, Gifu Graduate School of Medicine, Gifu, Japan.
  • Kato T; Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, Gifu, Japan.
  • Doi K; Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, Gifu, Japan. Electronic address: doi.kiyoshi.s0@f.gifu-u.ac.jp.
  • Matsuhashi N; Department of Gastroenterological Surgery, Pediatric Surgery, Gifu Graduate School of Medicine, Gifu, Japan. Electronic address: nobuhisa@gifu-u.ac.jp.
Int J Surg Case Rep ; 115: 109260, 2024 Feb.
Article en En | MEDLINE | ID: mdl-38219518
ABSTRACT

INTRODUCTION:

Reconstructed gastric tube ulcers are common complications of esophagectomy. When the pericardium is penetrated, digestive juices can cause severe cardiac inflammation, leading to an extremely poor prognosis. We report the first case of pericardial penetration of a constructed stomach tube via the posterior mediastinal route and the first use of subxiphoid pericardial drainage and continuous irrigation lavage. PRESENTATION OF CASE This case involved a 50-year-old woman who underwent an esophagectomy for esophageal cancer nine years prior with gastric tube reconstruction via the posterior mediastinal route. She developed pericardial penetration due to a gastric tube ulcer. Her respiratory and circulatory condition worsened, and pericardial drainage and a prophylactic tracheostomy were performed to prevent septic shock. A 5-cm longitudinal incision was made in the epigastric region, and a 4-cm T-shaped incision was made through the pericardium. Two double-lumen drainage tubes were placed in the anterior and posterior pericardium, and continuous irrigation was initiated via each tube. We successfully treated the patient without complications using subxiphoid pericardial drainage and continuous irrigation lavage, and she was discharged on postoperative day 23.

DISCUSSION:

We presented this case to discuss surgical techniques and optimal treatment strategies.

CONCLUSION:

Subxiphoid pericardial drainage and continuous irrigational lavage are effective for pericardial penetration of a constructed stomach tube via the posterior mediastinal route.
Palabras clave

Texto completo: 1 Bases de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Int J Surg Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Japón

Texto completo: 1 Bases de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Int J Surg Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Japón