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Perforated diverticulum: rare complication of interposed substernal colon
Yu-Jen Cheng1, Hsien-Pin Li, Eing-Long Kao
1Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. yujen.cheng@msa.hinet.net
The Annals of Thoracic Surgery
|July 26, 2006
Summary
Substernal colon interposition is a viable reconstruction for caustic ingestion injuries. A rare case highlights the risk of perforated diverticulitis in interposed colon, emphasizing its inclusion in differential diagnoses.
Area of Science:
- Gastroenterology
- Surgical Reconstruction
- Medical Case Reports
Background:
- Substernal colon interposition is a recognized reconstructive method following salvage surgery for caustic ingestion injuries.
- While complications like redundancy and reflux are known, perforated diverticula in interposed colon segments have not been previously reported in English literature.
Observation:
- A 23-year-old male patient underwent a substernal colon flap reconstruction after sustaining a caustic ingestion injury.
- Seven years post-reconstruction, the patient developed perforated colon diverticulitis, subsequently leading to a lung abscess.
Findings:
- The patient required resection of necrotic lung parenchyma and subsequent repair of the colon.
- This case represents the first reported instance of perforated diverticula occurring within an interposed colonic segment.
Implications:
- This rare presentation underscores the necessity of considering perforated diverticula in interposed colonic segments within the differential diagnosis for patients with similar surgical histories.
- Highlights potential long-term complications of colonic interposition grafts and the importance of vigilant follow-up.
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