Herniation of the transverse colon after esophagectomy: is retrocardiac air a normal postoperative finding?

Abstract

This study describes the radiographic and CT imaging features of colonic herniation complicating esophagogastrectomy in three patients, all of whom required surgery. After routine esophagogastrectomy with gastric pull-through for esophageal carcinoma, the intrathoracic gastric pull-through most often lies in a right paraspinal location. Once a left-sided gastric pull-through has been excluded, radiologists must be suspicious for left retrocardiac air lucency that possibly represents herniation of the nearby colon. Early diagnosis is important for the prevention of bowel strangulation, especially of the ischemia-susceptible splenic flexure.