This is a very rare complication even in this patient subgroup, restricted to those in whom the oesophagus is both replaced and the distal segment closed at both ends and abandoned in the mediastinum. Here, secretions continue and accumulate in the closed segment. These are mainly asymptomatic if they remain small, but can rarely become enlarged and cause respiratory symptoms, even respiratory distress. This is due to tracheobronchial compression, causing coughing, chest and abdominal pain and vomiting. Infection, fistulisation and ulceration has also occurred. Drainage and stabilisation of the patient, then resection, is the treatment of choice. (197–199)
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