Revision 3 for 'Anastomotic stricture post Ivor Lewis esophagectomy'

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Anastomotic stricture post Ivor Lewis esophagectomy

Proximal esophageal dilation with minimal retained is in keeping with the anastomotic stricture demonstrated earlier today. The left sided outpouching at the anastomotic site is characterized as some gas locules with no evidence of contrast within or signs to suggest free extravasation through the mediastinum. It is intimately related to a linear hyperdensity which may represent anastomotic sutures. Metallic clips and sutures noted in the mediastinum. The remainder of the mediastinal structures are unremarkable, no lymph node enlargement. Right apical bullae and features of centrilobular emphysema. No pulmonary consolidations. Small pleural effusion is again demonstrated on the right. No pneumothorax. Imaged superior abdomen is unremarkable for this protocol. No suspicious bone lesions. Conclusion: The out-pouching located just above the proximal anastomotic site may be a prestenotic diverticulum or chronic contained leakage site. However, given its relationship to the anastomotic sutures it is also possible that the outpouching is due to the configuration of the anastomosis.

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