Vol 62, No 6 (2012)
Case report
Published online: 2012-12-28
Emergency gastrectomy associated with transhiatal oesophagectomy. Difficult decisions on-call
Nowotwory. Journal of Oncology 2012;62(6):438-441.
Abstract
Surgical emergency procedures remain the most unpredictable operations. In this paper we describe a case of
a 44-years-old male patient with sudden peptic ulcer perforation a few days before planned esophagectomy with
simultaneous reconstruction for suspected c neoplastic stricture of the lower oesophagus. Emergency laparotomy
revealed large perforated ulceration (3 cm) in the pre-pyloric area and another ulceration in the sub-cardiac region.
Due to the high suspicion for oesophageal malignancy total gastrectomy with subtotal transhiatal oesophagectomy
were performed. As the patient was in septic shock and required intensive treatment during the initial operation the
delayed esophageal reconstruction was planned. Described case shows complex nature of emergency surgery with
multiple unexpected conditions at the same time. We describe our decisions making process as well as operative
steps to invite a discussion on management in such cases.
a 44-years-old male patient with sudden peptic ulcer perforation a few days before planned esophagectomy with
simultaneous reconstruction for suspected c neoplastic stricture of the lower oesophagus. Emergency laparotomy
revealed large perforated ulceration (3 cm) in the pre-pyloric area and another ulceration in the sub-cardiac region.
Due to the high suspicion for oesophageal malignancy total gastrectomy with subtotal transhiatal oesophagectomy
were performed. As the patient was in septic shock and required intensive treatment during the initial operation the
delayed esophageal reconstruction was planned. Described case shows complex nature of emergency surgery with
multiple unexpected conditions at the same time. We describe our decisions making process as well as operative
steps to invite a discussion on management in such cases.