TY - JOUR ID - 44369 TI - Closing a Tracheal Defect with an Omental Pedicled Gastric Flap; A Technical Note JO - Bulletin of Emergency And Trauma JA - BEAT LA - en SN - 2322-2522 AU - Rupprecht, Holger AU - Ghidau, Marius AU - Gaab, Katharina AD - Clinical Center Fuerth, Bavaria, Germany Y1 - 2017 PY - 2017 VL - 5 IS - Issue 2 SP - 129 EP - 131 KW - Pedicled flap KW - Surgical flap, Tracheal necrosis, Bronchial stump fistula DO - N2 - Due to an adenocarcinoma of the right upper lobe with infiltration of the main bronchus a 49-years-old female patient underwent an upper bilobectomy with sleeve resection. After two completed chemotherapy bouts and signs of sepsis another thoracotomy was inevitable.  As a complicating factor a supracarinal, necrotic and perforating lesion of the trachea appeared. The defect can be initially repaired with a suture and covered with azygos vein material. However surgical revision showed an enlargement of the tracheal necrosis. Then the lesion was occluded with a diaphragmatic pedicled flap. Nevertheless after the operation a tracheal insufficiency with massive ventilation leakage was observed. It was generated by the death of the diaphragmatic flap. As an ultimate therapeutic measure a transplantation of a pedicled omental gastric flap was performed, which in case of a failure of the conventional operative techniques, is an additional option in closing tracheal defects caused by infections. Especially in cases of massive infected thoracic cavity and tracheal necrosis omentum majus is, compared to muscle flaps, the better biological tissue to close and heal the tracheal defect. This case report firstly describes a successfully closure of a tracheal defect using the technique mentioned above. UR - https://beat.sums.ac.ir/article_44369.html L1 - https://beat.sums.ac.ir/article_44369_721df659454ba4649b25e8f6c3d5c52e.pdf ER -