Successful Treatment of Esophageal Necrosis Secondary to Acute Type B Aortic Dissection.

Abstract

Esophageal necrosis after descending aortic dissection has been described but with no reports of successful treatment. A 66-year-old man with aortic dissection extending from the left subclavian artery through the common iliac arteries subsequently experienced esophageal necrosis. He underwent thoracic esophagectomy, cervical end esophagostomy, and open gastrostomy tube placement. Gastrointestinal continuity was established with a gastric tube conduit in the substernal plane. An oral diet was tolerated after reconstruction. Treatment of esophageal necrosis after aortic dissection may require esophageal diversion and esophagectomy. Esophageal continuity can later be restored while avoiding the posterior mediastinum.