ABSTRACT
Perforation of a retrosternal interposed ileocolon is rare. We present a case of perforation of the interposed colon on the ninth postoperative day, which subsequently herniated to the right pleural space. We suggest that the dilated haustral trapping and the associated "waterfall" effect may have resulted in incarceration of the colon. Careful dissection of the pleura in order to create a retrosternal tunnel, and the use of a suitable length of an esophageal substitute could prevent this complication.
Subject(s)
Colon/surgery , Esophagoplasty/adverse effects , Esophagus/surgery , Hernia, Diaphragmatic/complications , Ileum/surgery , Intestinal Perforation/etiology , Anastomosis, Surgical/adverse effects , Dilatation, Pathologic , Empyema, Pleural/etiology , Esophagus/diagnostic imaging , Esophagus/injuries , Female , Hernia, Diaphragmatic/diagnostic imaging , Hernia, Diaphragmatic/surgery , Humans , Hydropneumothorax/etiology , Intestinal Perforation/diagnostic imaging , Intestinal Perforation/surgery , Middle Aged , Pleura/surgery , Radiography , Sternum/surgery , Time Factors , Treatment OutcomeABSTRACT
Heterotopic pancreas causing small bowel intussusception is rare. We report the case of a 24-year-old woman who presented with intermittent episodes of abdominal cramping and pain that had persisted for 10 days. A target-shaped lesion consisting of multiple concentric rings was found on the left side on contrast-enhanced computed tomography. Surgical intervention demonstrated jejunal intussusception caused by a jejunal heterotopic pancreas. Microscopically, several nesidioblastoses of pancreas were identified. Although very rare, small intestinal pancreatic rests may cause subacute bowel obstruction.
