Claude Bernard-Horner syndrome associated with colonic interposition grafting after esophagectomy

A 34 year-old male was admitted in our hospital because of double vision, ptosis of the eyelid, miosis and enopthalmos of the left eye together with impaired sweating of the upper body quarter for the last two weeks. Ten years ago the patient underwent total esophagectomy with colonic graft interposition because of esophageal rupture during large caliber bougienage for congenital esophageal stenosis. The endoscopy showed a large diverticulum below the upper esophageal sphincter and numerous ulcerations of the lower part of the colonic graft in the area of the former gastroesophageal junction. The patient was diagnosed with postganglionic Claude Bernard-Horner syndrome due to stellate ganglion compression from the colonic diverticulum. The patient was discharged with recommendations for liquid diet and body positions that could facilitate left stellate ganglion decompression. In the case of persisting symptoms the patient was advised about the possibility of a new surgical intervention including diverticulectomy. To the best of our knowledge this is the first reported case of Claude BernardHorner syndrome as a long term complication of colonic graft diverticle after esophagectomy for congenital esophageal stenosis