Necrose da mucosa esofágica como complicação da cardiomiotomia à heller para tratamento de megaesôfago chagásico

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Bibliographic Details
Main Author: Aires, Nádia Barbosa
Publication Date: 2002
Other Authors: Cruz, Carlos Augusto Teixeira, Vianna, André Luiz
Format: Article
Language: por
Source: Repositório Institucional da UnB
Download full: http://repositorio.unb.br/handle/10482/25868
https://dx.doi.org/10.1590/S0100-69912002000500012
Summary: This article presents a complication of the laparoscopic technique for Heller cardiomyotomy and anterior fundoplication. This procedure is safe and provides excellent relief of disphagia in esophageal achalasia. Nevertheless, there are rare but dangerous complications, such as late active digestive bleeding, presented in this paper which was resistant to conservative treatment and led to hypovolemic shock. Urgent laparotomy performed to identify and control bleeding, revealed necrosis of esophageal mucosa with a bleeding gastric vessel. Inadequate exposure of the gastroesophageal junction and an incision very close to the lesser curvature might have damaged the esophageal branches of the left gastric artery, leading to ischemic necrosis of the mucosa and exposure of the gastric wall and its vessels.