Adhesive Colonic Obstruction After Esophageal Reconstruction: An Uncommon Late Complication.

Adhesive colonic obstruction is a rare but clinically significant late complication following esophageal reconstruction with colon interposition. This case report describes a 68-year-old woman with a history of caustic esophageal injury and colonic interposition, presenting 12 years postoperatively with acute intolerance to oral intake and thoracic colonic distension. Imaging and endoscopy confirmed mechanical obstruction due to an adhesion. Surgical adhesiolysis restored conduit patency, resulting in uneventful recovery. This case highlights the importance of long-term surveillance and prompt multidisciplinary management for late mechanical complications in colonic interposition patients, as late morbidity - including obstruction, redundancy, and stricture - can occur years after initial surgery and may require surgical intervention to preserve conduit function and patient quality of life.