History: 34 yo male with progressive dysphagia presents for Upper GI examination. History of surgery as a child.
Solution: Ileocolonic interposition
The findings in this case are contrast filling a segment of ileum and colon within the right chest. The contrast is then draining into the stomach. Given this appearance, the only possibility is the the surgery that this patient underwent as a child was an ileocolonic interposition. The reason for the surgery is not known based upon the images, but could include esophageal atresia (as in this case), caustic ingestion, radiation esophagitis with stricturing, or any other cause of esophageal stricturing, particularly diffuse and is usually performed in pediatric patients for benign disease.
Unfortunately, one of the complications of the procedure is chronic reflux with associated inflammatory changes and stricturing, which had occurred in this patient and required repeat dilatations and was resistant to therapy.
The findings in this case are contrast filling a segment of ileum and colon within the right chest. The contrast is then draining into the stomach. Given this appearance, the only possibility is the the surgery that this patient underwent as a child was an ileocolonic interposition. The reason for the surgery is not known based upon the images, but could include esophageal atresia (as in this case), caustic ingestion, radiation esophagitis with stricturing, or any other cause of esophageal stricturing, particularly diffuse and is usually performed in pediatric patients for benign disease.
Unfortunately, one of the complications of the procedure is chronic reflux with associated inflammatory changes and stricturing, which had occurred in this patient and required repeat dilatations and was resistant to therapy.
Radiograph Images
