USE OF FLUORESCEIN TO PREDICT SURVIVAL OF A FREE JEJUNAL TRANSFER AFTER DISRUPTION OF THE ARTERIAL PEDICLE ON POSTOPERATIVE DAY-12

The arterial pedicle to a free jejunal transfer was inadvertently disr upted on the 12th postoperative day. Intravenous fluorescein indicated viability of the entire jejunal transfer except for a 2 cm diameter a rea on the antimesenteric border midway between the upper and lower en teric anastomoses. The entire jejunum survived except for the small ar ea which failed to fluoresce; this area was converted to a controlled pharyngocutaneous fistula. Neovascularisation from surrounding, unirra diated tissue can allow survival of a free vascularised jejunal transf er after disruption of arterial inflow as early as 12 days postoperati vely.