A word of caution with oesophageal replacement for corrosive oesophageal injury! A case report

Corrosive ingestion remains a common problem in developing countries such as India due to the lack of strict laws that regulate the sale of caustics. Corrosives can damage any segment of the gastrointestinal tract. The chronic phase of corrosive injuries may result in several complications, with the most common among them being stricture. These chronic sequelae are frequently managed by esophageal replacement. Due to the associated injury to the larynx and the trachea, the airway management is complicated in the late phase when fibrosis and strictures distort the anatomy. We present a case of a patient with corrosive esophageal injury scheduled for a colonic pullup. Pneumothorax is a recognized complication of esophageal replacement. In this case, the scarred airway with a delayed postoperative pneumothorax created a catastrophic situation. This case report draws attention to the possibility of a disaster following esophageal replacement in patients with corrosive injury when postoperative lung complications compound a distorted airway. During such an emergency, strict vigilance and proper planning with early corrective measures is imperative.