Presentation
Post Ivor-Lewis esophagectomy. Increased nausea and vomiting.
Patient Data
Findings: There is anastomotic narrowing at the anastomosis site with proximal esophageal dilatation and delayed contrast emptying. Contrast outpouch irregular filling at the left aspect of the anastomosis site appears to represent a contained leakage point, which clears up with the contrast progression. The contrast media otherwise progresses normally through the stomach and proximal duodenum.
Conclusion: Features are consistent with anastomotic stricture and small anastomotic contained leakage point.
Case Discussion
Features are those of anastomotic stricture after an Ivor Lewis procedure. The out-pouching located just above the proximal anastomotic site may be a pre-stenotic diverticulum or chronic contained leakage site.