[Rare late complication after subtotal esophagectomy].
We report a case of a peptic ulcer developed in the stomach tube used for the replacement of the esophagus. The patient was a 60 years old female who had undergone subtotal esophagectomy for mid esophageal malignancy, with intrapleural stomach replacement. Urgent endoscopy revealed an excavated, bleeding ulcer in the thoracic part of the stomach. After unsuccessful medical treatment urgent operation was performed via right thoracotomy. Opening the stomach an ulcer was found on the posterior wall of the stomach, it was penetrating to the right atrium of the heart. The bleeding was controlled by suturing the atrium wall. The patient treated with i.v. Omeprazol in the postoperative period. On the 21st postoperative day a rebleeding occurred causing shock. After reoperation the patient died. This complication is very rare. We emphasise the importance of postoperative pH measurement investigations showing the presence of duodenogastric reflux disease.
Farsang
Z
Z
Semmelweis Egyetem Egészségtudományi Kar Sebészeti Klinika, 1135 Budapest, Szabolcs u. 33-35. farsangz@hotmail.com
Vörös
A
A
Szántó
I
I
Gonda
G
G
Ender
F
F
Altorjay
A
A
D016629:Esophagectomy / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D012008:Recurrence; D012086:Reoperation; D012771:Shock, Hemorrhagic / Q000209:etiology; D013270:Stomach / Q000473:pathology* / Q000637:transplantation*