Use of fluorescein to predict survival of a free jejunal transfer after disruption of the arterial pedicle on postoperative day 12.

The arterial pedicle to a free jejunal transfer was inadvertently disrupted on the 12th postoperative day. Intravenous fluorescein indicated viability of the entire jejunal transfer except for a 2 cm diameter area on the antimesenteric border midway between the upper and lower enteric anastomoses. The entire jejunum survived except for the small area which failed to fluoresce; this area was converted to a controlled pharyngocutaneous fistula. Neovascularisation from surrounding, unirradiated tissue can allow survival of a free vascularised jejunal transfer after disruption of arterial inflow as early as 12 days postoperatively.