Learning Radiology xray montage

Interposition of the Colon

General Considerations

    • Both the stomach and colon can be used as a substitute for the esophagus
    • The indication for the procedure is usually malignancy of the esophagus; benign conditions include esophageal atresia and strictures from caustic esophagitis
    • The stomach is more frequently used than the colon today
    • When the colon is used, it is aligned so that peristalsis proceeds in the normal caudal direction
    • The left colon is usually used because of its vascular supply
    • Complications include ischemia, anastomotic leak and strictures

    Interposition of the Colon

    The colon, outlined by swallowed barium, is seen interposed between the proximal esophagus and the stomach.

    Colon Interposition for Esophageal Replacement: An Alternative Technique Based on the Use of the Right Colon. Heinrich Fürst, MD, Wolfgang Hugo Hartl, MD, Florian Löhe, MD, and Friedrich Wilhelm Schildberg, MD. Ann Surg. 2000 Feb; 231(2): 173–178. 

    Colonic Interposition. Farooq Agha and Mark Orringer. AJR. 142, April, 1984.