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Updated: Jul 15, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
09:40

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

Published on: April 17, 2020

Esophagectomy for complications of esophageal intramural pseudodiverticulosis

M-P Thibodeau1, C Brigand, P Ferraro

  • 1Department of Surgery, Université de Montréal, Division of Thoracic Surgery, Center hospitalier de l'Université de Montréal, Montréal, Québec, Canada.

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
|April 19, 2007
PubMed

Insights

Esophageal intramural pseudodiverticulosis can cause serious complications like mediastinal abscesses. Surgical intervention, including subtotal esophagectomy and gastric tube reconstruction, successfully resolved the patient's condition and restored swallowing.

Area of Science:

  • Gastroenterology
  • Thoracic Surgery
  • Surgical Oncology

Background:

  • Esophageal intramural pseudodiverticulosis (EIP) is a rare condition characterized by the herniation of the esophageal mucosa through the muscularis propria.
  • Complications of EIP, such as fistulization and abscess formation, are uncommon but can lead to significant morbidity.

Observation:

  • A patient presented with sepsis secondary to a mediastinal abscess caused by EIP.
  • Initial management included antibiotics and spontaneous drainage of the abscess into the esophageal lumen.
  • A distal esophageal stricture developed, refractory to endoscopic dilations.

Findings:

  • Subtotal esophagectomy with a substernal gastric tube reconstruction was performed.
  • The surgical approach involved a right thoracic incision followed by laparotomy and left cervical anastomosis.
  • Postoperative recovery was uneventful, with the patient achieving normal swallowing function.

Implications:

  • This case highlights a rare but severe presentation of EIP.
  • Surgical management, including esophagectomy and gastric reconstruction, can be effective for complex EIP complications.
  • Early recognition and multidisciplinary management are crucial for optimizing outcomes in patients with esophageal pseudodiverticulosis.

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