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Colonic interposition: radiographic evaluation.

F P Agha, M B Orringer

    AJR. American Journal of Roentgenology
    |April 1, 1984
    PubMed
    Summary
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    Colon interposition for esophageal substitution is effective, with most complications manageable. This study details clinical and radiographic findings, including a novel finding of asymptomatic "jejunization" of the colon.

    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Radiology

    Background:

    • Esophageal substitution with colon is a common procedure for benign and malignant esophageal diseases.
    • Postoperative complications can significantly impact patient outcomes.

    Purpose of the Study:

    • To review the clinical and radiographic features of patients undergoing visceral esophageal substitution with colon.
    • To identify the incidence and radiographic characteristics of early and late postoperative complications.

    Main Methods:

    • Retrospective review of 40 patients who underwent colon interposition for esophageal lesions.
    • Routine postoperative barium esophagrams and, if needed, water-soluble contrast studies.
    • Long-term follow-up barium esophagrams in 24 patients.

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    Main Results:

    • Eight patients (21%) developed asymptomatic "jejunization" of colonic mucosa, resolving within 1-3 months.
    • Early complications included anastomotic leaks (6) and aspiration (8).
    • Late complications included anastomotic narrowing (12), impaired colonic emptying (5), and recurrent aspiration pneumonia (3).

    Conclusions:

    • Colon interposition is a viable option for esophageal substitution.
    • Radiographic monitoring is crucial for identifying both common and novel complications like "jejunization".
    • Understanding the spectrum of complications aids in patient management and outcome prediction.