PMC5989256_01
Esophagography with gastrograffin swallow showing contrast leakage through an esophageal fistula
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Gastrograffin swallow x-ray demonstrated signs of a pharyngo-esophageal rent as leakage of the contrast mean into the upper mediastinum (Figure 1).
Intraoperative photograph showing an esophageal wall defect and a nasogastric tube (white arrow)
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By a left lateral cervical approach, the fistula tract ahead of the neurovascular pedicle was followed deeply to the left lateral pharyngo-esophageal rent (Figure 2).
Intraoperative photographs: the esophageal fistula was closed using 3-0 Vicryl (wight arrow), then a pediculed SCM muscular flap (wight star) was elevated, medially rotated and interposed between the esophagus and the cervical column to protect the viscus repair (black star)
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A superiorly based SCM muscular flap was then elevated, medially rotated and interposed between the esophagus and the cervical column to protect the viscus repair (Figure 3).