Jejunal Loop Stenosis after Surgery for Esophageal Cancer

Ryohei Ishibe, Koki Tanaka, Kazuhiko Yamada, Naoki Ishizaki, Akihiro Nishimura, Meguru Yoshimine, Mikio Fukueda, Koji Shirahama, Akira Taira

The Second Department of Surgery, Kagoshima University Faculty of Medicine

A 67-year-old woman complained of increasing dysphagia after an operation for esophageal cancer. The symptom first appeared in the second postoperative month. Esophagoscopy disclosed scar formation on the jejunal loop, 7-8 cm distal to the anastomosis. Histological examination suggested a postischemic lesion and subsequent scar formation. Circulatory disturbance due to compression or overstretching that affected the mesenteric vessel was considered likely. Bougienage was not effective. Reoperation was abandoned because of the non-curative outcome of the initial operation, anticipation of a difficult reoperation and disapproval by the patient. An esophageal prosthesis was then selected to solve the problem. Her dysphagia was improved markedly. She is doing well with an almost normal diet four months after discharge. The esophageal prosthesis is a valuable tool for the patient with inoperable and/or unsuccessful bougienage stenosis. However further follow-up for a long period is required.

Key words
jejunal loop stenosis, circulatory disturbance, esophageal prosthesis

Reprint requests
Ryohei Ishibe The Second Department of Surgery, Kagoshima University Faculty of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
April 14, 1993

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