Laparoscopic transhiatal management of a rare case of esophageal lung and medialized stomach associated with heterotaxy – a technical case report
Abstract
Introduction: Esophageal lung is a rare and complex congenital malformation, in which the bronchus of one or several pulmonary lobes arises from the esophagus. It is frequently associated with other malformations. Surgical management needs individual approaches, is often complex and depends on concomitant disorders. Case description: A 3-month-old male was referred for further management of a left lower esophageal pulmonary lobe associated with a laryngotracheal cleft, congenital heart disease, heterotaxy, medialized stomach with additional microgastria and severe gastroesophageal reflux leading to recurrent left lower lobe pneumonia. Technical management: A minimally invasive, laparoscopic strategy via abdominal access only was used to cure the gastroesophageal reflux and recurrent pneumonias. Laparoscopic dissection of the thoracic esophagus was performed up to the junction of the aberrant left lower lobe bronchus, which was subsequently clipped, avoiding gastroesophageal reflux into the left lower lobe. Fundoplication and laparoscopic gastrostomy were performed simultaneously. The patient underwent closure of the laryngotracheal cleft in a second procedure. Conclusion: Transhiatal clip ligation is an innovative approach to esophageal lower pulmonary lobes. The intervention prevents recurrent pneumonias associated with aspiration of feeds and gastroesophageal reflux. Whether an interval lobectomy is necessary at a later date must be determined by the clinical course.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use
- Ivth brazilian consensus conference on helicobacter pylori infection
- A pSMAD/CDX2 complex is essential for the intestinalization of epithelial metaplasia
- S2k-Leitlinie Gastroösophageale Refluxkrankheit und eosinophile Ösophagitis der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – März 2023 – AWMF-Registernummer: 021–013
- Step-by-step management of refractory gastresophageal reflux disease
- Insights into Effects/Risks of Chronic Hypergastrinemia and Lifelong PPI Treatment in Man Based on Studies of Patients with Zollinger–Ellison Syndrome
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.