Peripheral athero-embolism from the aorta complicating transhiatal esophagectomy.

The clinical courses of two patients with moderate atherosclerotic aneurysmal dilation of the upper abdominal aorta suffering significant thrombo-embolic sequelae following transhiatal esophagectomy are presented. Inadvertent dislodgement of debris from the diseased aorta during the course of the hiatal and intrathoracic "blunt" dissection was felt to be responsible for this uncommon postoperative problem. This potential complication should be kept in mind when operating near the esophageal hiatus during the course of esophagectomy in such vasculopathic patients.