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Delayed Onset Free Jejunal Flap Necrosis due to Thrombosis: A Case Report
Ken Kasahara1,2, Yoichiro Sato1, Ko Hentona1
1Department of Otolaryngology, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
The Laryngoscope
|July 15, 2025
Summary
Late jejunal flap necrosis due to vascular thrombosis is rare. Early detection and salvage surgery in a patient over two years post-reconstruction led to a successful outcome, emphasizing monitoring.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Vascular Surgery
Background:
- Free jejunal flaps are utilized in reconstructive surgery.
- Vascular anastomosis thrombosis is a known complication, typically occurring earlier.
- Late-onset jejunal flap necrosis is an uncommon presentation.
Observation:
- A 68-year-old male patient presented with symptoms of free jejunal necrosis.
- The necrosis was detected over two years after the initial reconstruction surgery.
- The patient's condition was successfully managed with salvage surgery.
Findings:
- Vascular anastomosis thrombosis led to late jejunal flap necrosis.
- Early detection of necrosis was crucial for successful salvage.
- Prompt surgical intervention prevented the development of severe infection.
Implications:
- Regular monitoring and documentation of the jejunal flap's internal lumen are clinically important.
- The possibility of delayed jejunal flap necrosis should be considered in long-term follow-up.
- This case underscores the importance of vigilance in post-operative care for reconstructive surgery patients.
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