A Patient in Respiratory Distress After Esophagectomy

[摘要] Figures Figure 1 Chest radiograph (postoperative day 9) demonstrating a moderate left hydropneumothorax with left lower lobe atelectasis, right lower lung consolidation, persistent postsurgical changes of esophagectomy, and left upper abdomen prominent loop of bowel. Figure 2 Chest radiograph (postoperative day 9 post-nasogastric tube placement) demonstrating a newly placed nasogastric tube descending through the gastric conduit (gastric pull-up) and projecting within the medial aspect of the left hemithorax, unchanged moderate left hydropneumothorax, decreased left lower lobe atelectasis, unchanged right lower lung consolidation, and persistent dilated bowel loops. We present the case of a woman in her 40s who underwent a McKeown esophagectomy for the treatment of proximal to middle esophageal squamous cell carcinoma after treatment with neoadjuvant chemotherapy and radiation therapy. This extensive procedure included a right-sided thoracotomy, total thoracic esophagectomy, gastric mobilization, development of gastric conduit with pyloroplasty to facilitate gastric emptying, and finally substernal placement of the gastric conduit (gastric pull-up) with anastomosis to the cervical esophagus.

[学科分类] 呼吸医学