Substernal Colon Volvulus with Ischemia 43 Years after Reconstruction for Esophageal Atresia

Children with esophageal atresia, without airway fistula, have several options for repair including reconstruction with the stomach, jejunum, or colon, with the latter being the preferred conduit.1- 2 Stricture of the coloesophageal anastomosis requiring dilation is also a well-described complication from colon interposition.23 3 long-term complications are redundancy, ischemia, necrosis, reflux, ulceration, and cancer.1, 4 These procedures are complex and require lifelong surveillance to monitor for complications. The patient had a cervical diverting esophagostomy at birth for pure esophageal atresia and subsequently underwent a substernal colon interposition with coloesophageal and cologastric anastomoses at the age of 1. Patients with substernal colon conduits require periodic surveillance during their lifetime for potential complications due to dilation, redundancy, and risk for cancer.