An Ulcer in the Gastric Tube Used for Esophageal Replacement after Esophagectomy — Report of a Case

Abstract

Abstract: We report a patient with an asymptomatic recurrent peptic ulcer occurring in the gastric tube after reconstruction for esophagectomy with a long follow‐up. The patient is an 82‐year‐old male, who had undergone an esophagectomy for cancer, and a gastric tube was used for esophageal replacement at the age of 77 years. A follow‐up study using endoscopic examination revealed an active peptic ulcer in the gastric tube one year after the operation, ulcer scar formation 9 weeks after H2 receptor antagonist medication, and recurrence of the ulcer about 3 years after quitting the medication. The recurrent active ulcer has disappeared after re‐administration of H2 receptor antagonist. Helicobacter pylori has not been detected, although eradication has not been per formed. It is suggested that high acidity might play a part in the pathogenesis of ulcer formation despite the vagotomy. Since a peptic ulcer in the gastric tube can potentially cause serious complications including perforation and hemorrhage, we have to bear in mind not only recurrence of the cancer but also gastric tube ulceration in the follow‐up survey after esophagectomy, to facilitate early detection of ulcer and effective treat ment. (Dig Endosc 1999:11: 62–65)