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The Annals of Thoracic Surgery, Vol 43, 263-269, Copyright © 1987 by The Society of Thoracic Surgeons
MV Kamath, RG Ellison, JW Rubin, HV Moore and GP Pai
Mucocele of the bypassed esophagus is an unusual complication of esophageal
replacement and has been described only in isolated references. This report
is based on our experience with 6 patients in whom a mucocele developed
following esophageal replacement. Esophageal replacement was performed on
37 patients over a 10-year period at the Medical College of Georgia
Hospital. A symptomatic mucocele requiring excision developed in 3 patients
with achalasia, 1 with congenital tracheoesophageal fistula, 1 with
esophageal atresia, and 1 with inflammatory stricture. Conduits used
included stomach (4), reversed gastric tube (1), and colon (1). Our
experience indicates that conversion of a closed-loop esophagus into a
symptomatic mucocele is more likely in the presence of functioning,
chronically irritated mucosa. The clinical features were referable to the
mucocele itself or respiratory embarrassment therefrom. Thoracic
roentgenograms and computed tomographic scans were diagnostic in verifying
the presence of the esophageal mucocele. All five mucoceles arose from
squamous epithelium. One of 3 patients with achalasia in whom a mucocele
developed following esophageal replacement had premalignant changes in the
mucosa. Based on this experience, our treatment of choice is early,
complete excision of the mucocele.
ARTICLES
Esophageal mucocele: a complication of blind loop esophagus
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