Ileo-right hemi-colonic cervical pull-up on a non-supercharged ileocolic arterial pedicle: A technical and case report

Figure 1 Secondary reconstruction with an ileo-right hemi-colonic cervical pull-up on a non-supercharged ileocolic arterial pedicle. A, B: Before and after emergency esophagectomy, gastrectomy, duodenectomy and pancreatectomy due to a caustic injury with hydrochloric acid; C, D: Esophageal reconstruction with transverse and descending colon fails due to ischemic demarcation → consecutive resection of transverse and descending colon including the distal part of the ascending colon; E: A short stump of the right hemi-colon and approximately 40 cm of descending colon were left in situ, connected via a colo-colonic anastomosis; F: Esophageal reconstruction with an ileo-right hemi-colonic cervical pull-up on a non-supercharged ileocolic arterial pedicle in an isoperistaltic direction; G: Situation 9 mo after reconstruction: The cecal part of the pulled-up graft had moved downwards from the thoracic cavity into the abdomen and largely dilated, causing recurrent episodes of bowel obstruction; H: Final result: The ileocecal region was resected and an ileo-jejunostomy was formed.