Peptic ulcer of the gastric tube after esophagectomy for cancer: clinical implications.
The use of the stomach as an esophageal substitute has become a well-established treatment procedure after esophagectomy for cancer. During the procedure, a bilateral truncal vagotomy is performed, which should prevent the occurrence of acid-related diseases in the gastric tube and in the remaining esophagus. We report the case of a man who presented a plugged perforated peptic ulcer that subsequently decompensated following endoscopic examination 1 year after a transthoracic esophagectomy with neoadjuvant chemo-radiation for a middle third squamous cell carcinoma. Resection of the ulcer and suture with a pleural patch was performed. There was no evidence of recurrent malignancy at time of surgery. The pathophysiology of gastric tube ulcer is multifactorial. Long-term treatment with an anti-secretory proton pump inhibitor may decrease esophageal complications of duodeno-gastric-esophageal reflux and could prevent the recurrence of gastric tube ulcers.
Piessen
G
G
Department of Digestive and General Surgery, University Hospital Claude Huriez, Lille, Cedex, France.
Lamblin
A
A
Triboulet
J-P
JP
Mariette
C
C
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016629:Esophagectomy; D006801:Humans; D008297:Male; D010437:Peptic Ulcer / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed