REFERRAL LETTER

We have a 30 years old female patient Sumaira w/o Khalil, previously referred to our ward Surgical-4, CHK from SIUT, Karachi for Esophagectomy.
She is a diagnosed case of Esophageal cancer (moderately differentiated infiltrative focally keratinizing squamous cell carcinoma) and has received neoadjuvant chemoradiotherapy.
Post-chemo CT scans show regression of previously noted heterogenous mass in the wall of the esophagus. However, there is circumferential wall thickening of esophagus. We carried out OGD (osophago-gastro-duodenoscopy) in our Ward before planning an esophagectomy which showed a possible esophageal opening of a Tracheo-esophageal fistula (TE Fistula).
We are referring this patient back again to your institute for further evaluation and management of the TE Fistula if present.
Looking forward for your cooperation.


DOD
Surgical-4 ward.
4th August, 2015.