Duodenoesophageal fistula as a rare complication following emergency total gastrectomy for caustic injury.

Duodenoesophageal fistula (DEF) has not been previously reported. We present a case of DEF connecting the duodenal stump and the intra-abdominal esophageal stump following an emergency total gastrectomy without reconstruction due to caustic injury. Additionally, we describe our experience with one-stage surgical management of the fistula, along with digestive tract reconstruction. The patient underwent emergency surgery approximately 6 months prior at another hospital and was subsequently referred to our center for esophageal reconstruction. Preoperative investigations revealed the presence of DEF along with jejunal obstruction at the site of feeding jejunostomy (FJ) placement, as well as caustic strictures of the esophagus. Thoracoscopic esophagectomy, detachment of the FJ with segmental small bowel resection, duodenoesophageal fistulectomy with resection of the duodenal stump defect, and colonic interposition were successfully performed. In this report, we present a rare condition and describe the successful surgical management of DEF. To the best of our knowledge, this type of fistula formation following emergency total gastrectomy for caustic injury and its management have not been previously described in the literature.