SUCCESSFUL APPLICATION OF AN OMENTAL PEDICLE FLAP IN DELAYED REPAIR OF A PERFORATED ESOPHAGEAL DIVERTICULUM - REPORT OF A CASE

Mediastinitis resulting from a perforated esophageal diverticulum is a potentially fatal complication and the surgical treatment of persiste nt esophagomediastinal fistula may be difficult. In this report, we de scribe the successful application of an omental pedicle flap in the de layed repair of a perforated esophageal diverticulum. A 53-year-old ma n presented with chest and back pain and a diagnosis of perforated eso phageal diverticulum was subsequently confirmed. After receiving conse rvative treatment, he was referred to our department and underwent sur gical repair 6 months following the onset of the perforation. Through a right thoracotomy, the mucosal layer of the esophagus around the div erticulum was sutured, and an omental pedicle flap was used to cover t he suture line and obliterate the fistulous tract. His postoperative c ourse was uneventful and the suture line healed well. The successful t reatment of this patient reinforces our belief that wider application of the omental pedicle flap can be expected in the field of thoracic s urgery.