Subxiphoid pericardial drainage for gastric tube ulcer penetrating the pericardium after esophagectomy: A case report

被引:0
作者
Ohno, Shinya [1 ]
Tanaka, Yoshihiro [1 ,3 ]
Sato, Yuta [1 ]
Kato, Takayoshi [2 ]
Doi, Kiyoshi [2 ]
Matsuhashi, Nobuhisa [1 ]
机构
[1] Gifu Grad Sch Med, Dept Gastroenterol Surg, Pediat Surg, Gifu, Japan
[2] Gifu Univ, Grad Sch Med, Dept Gen & Cardiothorac Surg, Gifu, Japan
[3] Gifu Univ, Gifu Grad Sch Med, Dept Gastroenterol Surg, Pediat Surg, 1-1 Yanagido, Gifu 5011194, Japan
来源
INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS | 2024年 / 115卷
关键词
Esophageal cancer; Surgical drainage; Continuous irrigational lavage; Posterior mediastinal route;
D O I
10.1016/j.ijscr.2024.109260
中图分类号
R61 [外科手术学];
学科分类号
摘要
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.
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页数:5
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