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Updated: May 17, 2025
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Fluoroscopic balloon dilation is effective for anastomotic leakage caused by compression due to intraperitoneal
Teppei Kamada1, Hironori Ohdaira1, Takashi Aida1
1Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan.
Rationale:
There have been no reports of delayed anastomotic leakage of the ileum caused by compression of an intra-abdominal hematoma due to postoperative bleeding after ileostomy closure.
Patient Concerns:
We report the case of a 44-year-old man with delayed anastomotic leakage after ileostomy closure caused by the compression of an intra-abdominal hematoma that healed quickly after fluoroscopic balloon dilatation of the bowel stenosis area.
Diagnoses:
Postoperative bleeding and hemorrhagic shock occurred on postoperative day 1 after ileostomy closure. Vital signs stabilized after blood transfusion, and computerized tomography-guided drainage was successfully performed to reduce the hematoma volume. However, residual hematoma compressed the ileum on the anal side of the anastomosis, leading to delayed anastomotic leakage.
Interventions/Outcomes:
Fluoroscopic balloon dilation of the stenotic area through the drain was successfully performed, and the anastomotic leakage healed quickly.
Lessons:
In cases of small intestinal anastomotic leakage after postoperative bleeding, compression of the intestinal tract due to a hematoma should be considered. Fluoroscopic balloon dilation through a drain is an effective procedure.
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