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28.01.2024 | Case Report

Minimally invasive surgery for esophagogastric junction cancer with Leriche’s syndrome-induced ischemic enteritis in the rectum: A case report

verfasst von: Yutaro Ogawa, Tomohiko Yasuda, Hiroki Arai, Takahiko Mine, Daisuke Kakinuma, Keisuke Minamimura, Satoshi Matsumoto, Masanori Watanabe, Yoshiharu Nakamura, Hiroshi Yoshida

Erschienen in: Clinical Journal of Gastroenterology | Ausgabe 2/2024

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Abstract

The incidence of esophagogastric junction cancer has been increasing, leading to growing interest in surgical treatment. Leriche syndrome, characterized by occlusion limited to the infrarenal aorta, has not been reported to be associated with ischemic enteritis, and there are no previous reports on the surgical approaches for esophagogastric junction cancer in this disease.

We describe the case of a male patient in his fifties with lower abdominal pain and melena who was diagnosed with esophagogastric junction cancer, Leriche syndrome, and ischemic enteritis. Contrast-enhanced computed tomography (CT) showed a hemorrhage from the cancer, occlusion of the abdominal aorta beyond the renal artery branches, and rectal contrast deficiency. Three-dimensional (3D)-CT angiography revealed occlusion from the lumbar artery bifurcation to the distal portions of both common iliac arteries plus numerous collateral pathways, indicating a precarious rectal blood supply. Based on 3D-CT angiography, minimally invasive surgery (MIS) using laparoscopy and thoracoscopy for esophagogastric junction cancer was performed after whole-body control. The patient was discharged without any postoperative complications.

Esophagogastric junction cancer with Leriche syndrome can be complicated by ischemic enteritis due to tumor bleeding and fragile collateral pathways. MIS using laparoscopy and thoracoscopy guided by 3D-CT angiography can be safely performed for this disease.

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Titel: Minimally invasive surgery for esophagogastric junction cancer with Leriche’s syndrome-induced ischemic enteritis in the rectum: A case report
verfasst von: Yutaro Ogawa
Tomohiko Yasuda
Hiroki Arai
Takahiko Mine
Daisuke Kakinuma
Keisuke Minamimura
Satoshi Matsumoto
Masanori Watanabe
Yoshiharu Nakamura
Hiroshi Yoshida
Publikationsdatum: 28.01.2024
Verlag: Springer Nature Singapore
Erschienen in: Clinical Journal of Gastroenterology / Ausgabe 2/2024
Print ISSN: 1865-7257
Elektronische ISSN: 1865-7265
DOI: https://doi.org/10.1007/s12328-023-01911-w

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