Use of Indocyanine Green Fluorescence Angiography and Prophylactic Endoscopic Stenting in Esophagectomy for Acute Esophageal Necrosis

Abstract

Acute esophageal necrosis (AEN) is a rare condition with high mortality. We describe a case of an AEN accompanied with multiple esophageal perforations in a 40-year-old patient. This was addressed via emergency Ivor-Lewis-esophagectomy with intraoperative Indocyanine-Green-Angiography (ICGA) and prophylactic placement of a self-expanding metal-stent (SEMS).

Zusammenfassung

Die akute Ösophagusnekrose (AEN) ist eine seltene Erkrankung mit hoher Sterblichkeit. Wir beschreiben einen Fall einer AEN mit multiplen Ösophagusperforationen bei einem 40-jährigen Patienten. Dieser Fall wurde erfolgreich durch eine notfallmäßige Ivor-Lewis-Ösophagektomie mit intraoperativer Indocyanin-Grün-Angiografie (ICGA) und prophylaktischer Platzierung eines selbstexpandierenden Metallstents (SEMS) behandelt.

Schlüsselwörter

akute Ösophagusnekrose - selbstexpandierender Metallstent - Indocyaningrün-Fluoreszenz-Angiographie - Ösophagusresektion - Ösophagusperforation

Keywords

acute esophageal necrosis - self-expanding metal-stent - indocyanin-green-fluorescence angiography - esophagectomy - esophageal perforation

Publikationsverlauf

Eingereicht: 11. Februar 2022

Angenommen nach Revision: 02. Juli 2022

Artikel online veröffentlicht:
22. November 2022

• References

• 1 Akaishi R, Taniyama Y, Sakurai T. et al. Acute esophageal necrosis with esophagus perforation treated by thoracoscopic subtotal esophagectomy and reconstructive surgery on a secondary esophageal stricture: a case report. Surg Case Rep 2019; 5: 73
• 2 Goldenberg SP, Wain SL, Marignani P. Acute necrotizing esophagitis. Gastroenterology 1990; 98: 493-496
• 3 Dias E, Santos-Antunes J, Macedo G. Diagnosis and management of acute esophageal necrosis. Ann Gastroenterol 2019; 32: 529-540
• 4 Sonavane AD, Gupta D, Ambekar A. et al. Acute esophageal necrosis: An uncommon entity. J Postgrad Med 2021; 67: 115-116
• 5 Ben Soussan E, Savoye G, Hochain P. et al. Acute esophageal necrosis: a 1-year prospective study. Gastrointest Endosc 2002; 56: 213-217
• 6 Rehman O, Jaferi U, Padda I. et al. Epidemiology, Pathogenesis, and Clinical Manifestations of Acute Esophageal Necrosis in Adults. Cureus 2021; 13: e16618
• 7 Lamers CR, Mares WGN, Bac DJ. Black esophagus: a case series and literature review of acute esophageal necrosis. Scand J Gastroenterol 2018; 53: 1421-1424
• 8 McLaughlin CW, Person TD, Denlinger CE. Management of acute esophageal necrosis syndrome. J Thorac Cardiovasc Surg 2011; 141: e23-24
• 9 Augusto F, Fernandes V, Cremers MI. et al. Acute necrotizing esophagitis: a large retrospective case series. Endoscopy 2004; 36: 411-415
• 10 Gurvits GE. Black esophagus: acute esophageal necrosis syndrome. World J Gastroenterol 2010; 16: 3219-3225
• 11 Imaoka K, Harano M, Oshita K. et al. Indocyanine green fluorescence imaging for subtotal esophagectomy due to esophageal stenosis after acute esophageal necrosis: a report of two cases. Clin J Gastroenterol 2021; 14: 415-421
• 12 Pineo CE, Pineo TZ. Acute oesophageal necrosis in a young man with cocaine and alcohol abuse. BMJ Case Rep 2016; 2016
• 13 Horvath P, Lange J, Stüker D. et al. Multimodal Treatment Strategies for Esophageal Perforation. Surg Laparosc Endosc Percutan Tech 2018; 28: 232-238
• 14 Zehetner J, DeMeester SR, Alicuben ET. et al. Intraoperative Assessment of Perfusion of the Gastric Graft and Correlation With Anastomotic Leaks After Esophagectomy. Ann Surg 2015; 262: 74-78
• 15 Chandler P, Wiesel O, Sherwinter DA. Fluorescence-guided surgery of the esophagus. Ann Transl Med 2021; 9: 908
• 16 Thammineedi SR, Patnaik SC, Saksena AR. et al. The Utility of Indocyanine Green Angiography in the Assessment of Perfusion of Gastric Conduit and Proximal Esophageal Stump Against Visual Assessment in Patients Undergoing Esophagectomy: a Prospective Study. Indian J Surg Oncol 2020; 11: 684-691
• 17 Slooter MD, Eshuis WJ, Cuesta MA. et al. Fluorescent imaging using indocyanine green during esophagectomy to prevent surgical morbidity: a systematic review and meta-analysis. J Thorac Dis 2019; 11: S755-s765