Esophageal stricture with Barrett’s esophagus due to alkaline reflux after total gastrectomy successfully managed by duodenal diversion

Abstract

A case of esophageal stricture with Barrett’s esophagus after total gastrectomy is reported herein. A 72-year-old woman was referred to our hospital because of dysphagia due to a stricture in the esophagus for 5 years. She had earlier undergone total gastrectomy followed by Billroth II reconstruction consequent to a gastric ulcer at the age of 49 years. She was diagnosed as having an esophageal stricture with Barrett’s esophagus. The 24-h pH monitoring indicated significant reflux of alkaline duodenal contents into the esophagus. The patient underwent duodenal diversion with Roux-en-Y reconstruction. The postoperative course has been uneventful, with no dysphagia and no dilatation. No change in the extent of Barrett’s esophagus has been observed to date at 7 years postoperatively. This case presented with development of Barrett’s esophagus and subsequently of esophageal stricture solely by duodenal reflux. Duodenal diversion was concluded to have been effective for esophageal stricture with Barrett’s esophagus after total gastrectomy.