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Nonanastomotic Strictures After Colonic Interposition

Diane X. Li1, Marc S. Levine1, Stephen E. Rubesin1 and Igor Laufer1

1 All authors: Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.


Figure 1
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  		Fig. 1A —55-year-old man with nonanastomotic stricture after colonic interposition for esophageal carcinoma. Frontal spot image from single-contrast upper gastrointestinal tract examination shows long segment of narrowing (white arrows) involving proximal two thirds of interposed colon. Note relatively smooth contour and tapered margins (long black arrows) of stricture. Esophagocolic anastomosis (short black arrow) is located proximally in upper chest just above aortic arch.

 

Figure 2
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  		Fig. 1B —55-year-old man with nonanastomotic stricture after colonic interposition for esophageal carcinoma. Frontal spot image from upper gastrointestinal tract examination with water-soluble contrast material 3 months before A shows relatively normal distention of proximal portion of interposed colon with effacement of haustral folds. Nodular indentations (white arrows) along left lateral wall of colon could be secondary to bowel wall edema or weak colonic contractions. Note esophagocolic anastomosis (black arrow) in upper chest below medial end of left clavicle.

 

Figure 3
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  		Fig. 2 —27-year-old man with nonanastomotic stricture after colonic interposition for chronic lye stricture. Double-contrast upper gastrointestinal tract examination shows moderately long stricture (white arrows) in lower one third of interposed colon. Note smooth contour and tapered margins (black arrows) of stricture.

 

Figure 4
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  		Fig. 3 —25-year-old man with nonanastomotic stricture after colonic interposition for VATER (vertebral defects, imperforate anus, tracheoesophageal fistula, and radial and renal dysplasia) syndrome with congenital esophageal stenosis. Single-contrast upper gastrointestinal tract examination shows 3.5-cm-long stricture (white arrows) in midportion of interposed colon. This tight stricture is causing partial obstruction with proximal colonic dilatation. Note smooth contour and tapered margins of stricture. Also note proximal esophagocolic anastomosis (black arrow) and Harrington rod in thoracic spine.

 

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