A successful rescue with extra-anatomical bypass for massive bleeding of the brachiocephalic artery following salvage pharyngo-esophagectomy

Massive bleeding from large vessels is a serious and life-threatening complication after radical esophagectomy. Here, we present the rare case of patient survival following two episodes of massive bleeding from a tracheo-brachiocephalic artery fistula after salvage surgery for cervical esophageal ca...

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Veröffentlicht in:Esophagus : official journal of the Japan Esophageal Society 2012-03, Vol.9 (1), p.39-43
Hauptverfasser: Gyobu, Ken, Osugi, Harushi, Lee, Shigeru, Kishida, Satoru, Okawa, Masato, Iwasaki, Hiroshi, Niwa, Yukiko, Hashiba, Ryoya, Edagawa, Eijiro, Ishida, Sachiko, Hirai, Hidekazu, Suehiro, Shigefumi
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container_title Esophagus : official journal of the Japan Esophageal Society
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creator Gyobu, Ken
Osugi, Harushi
Lee, Shigeru
Kishida, Satoru
Okawa, Masato
Iwasaki, Hiroshi
Niwa, Yukiko
Hashiba, Ryoya
Edagawa, Eijiro
Ishida, Sachiko
Hirai, Hidekazu
Suehiro, Shigefumi
description Massive bleeding from large vessels is a serious and life-threatening complication after radical esophagectomy. Here, we present the rare case of patient survival following two episodes of massive bleeding from a tracheo-brachiocephalic artery fistula after salvage surgery for cervical esophageal cancer following definitive chemoradiation. During the first episode of bleeding, the damaged part of the brachiocephalic artery was transected with an extra-anatomical arterial bypass (right femoro-axillo artery bypass graft) to maintain the arterial blood flow to the brain and the free jejunal graft. During the second bleeding, the distal stump of the brachiocephalic artery was reclosed. During both episodes of bleeding, the musculocutaneous flap was effectively employed to seal the stumps of the brachiocephalic artery and fill the dead space. Finally, the patient was discharged 351 days after the first surgery. (132/150).
doi_str_mv 10.1007/s10388-011-0303-7
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source SpringerNature Journals
subjects Case Report
Esophageal cancer
Esophagus
Gastroenterology
Gastrointestinal surgery
Medicine
Medicine & Public Health
Surgical Oncology
Thoracic Surgery
Throat surgery
Veins & arteries
title A successful rescue with extra-anatomical bypass for massive bleeding of the brachiocephalic artery following salvage pharyngo-esophagectomy
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