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Perforation of a Substernal Interposed Ileocolon Caused by Right Thoracic Herniation

Department of Surgery, Taipei County Hospital, Taipei, Taiwan

For reprint information contact: Va-Kei Kok, MD, Tel: 886 2 2351 1176, Fax: 886 2 2395 5097, Email: kokvakei{at}ms29.hinet.net, Department of Surgery, Taipei County Hospital, 5^th Floor, No.17, Lane 12, Qing Tian Street, Taipei 106, Taiwan.

Perforation of a retrosternal interposed ileocolon is rare. We present a case of perforation of the interposed colon on the ninth postoperative day, which subsequently herniated to the right pleural space. We suggest that the dilated haustral trapping and the associated "waterfall" effect may have resulted in incarceration of the colon. Careful dissection of the pleura in order to create a retrosternal tunnel, and the use of a suitable length of an esophageal substitute could prevent this complication.