A Case of Esophageal Stricture suspected due to Drug-induced Ulcer after Subtotal Esophagectomy

Shuzo Kohno, Yutaka Oda, Hideichiro Ohmori, Takenori Hada, Kazuto Sasaya^* and Yoji Yamazaki^*

Department of Surgery, National Sanatorium Higashi Utsunomiya Hospital Department of Surgery^*, The Jikei Univertity School of Medicine

A 59-yr-old male underwent treatment with antitubercular durg against pulmonary tuberculosis and radiation therapy against esophageal carcinoma from November, 1995. An esophagogastroscopy confirmed recurrent lesion formed 0-IIc+IIa type esophageal carcinoma on March 26, 1997. Subtotal esohagectomy was performed on May 7, 1997. On microscopic findings of surgical specimen, the depth was detected to muscularis mucosae, and no lymph node metastasis were shown (0/40). Detecting slight anastomotic stenosis but good passage on esophagogram, oral intake was started from May 20. Oral potassium therapy was started from June 13, and antitubercular drug (INH, REP, EB) therapy from June 17. He complained of dysphagia from June 20. An esophagogastroscopy showed anastomotic stricture, ulcer and stases of tablets. As diagnosis of drug-induced esophageal ulcer and anastomotic stricture was made from clinical and endoscopic findings, we applied balloon dilation to the stricture. Since discontinuation oral potassium therapy, there has been no recurrence of anastomotic stricture. Because drug-induced eophageal injury can easily occur after surgery for esophageal carcinoma, careful selection of the treatment drug, its size and shape for oral administration should be considered.

Key words
esophageal stricture, drug-induced esophageal injury, esophagectomy

Reprint requests
Shuzo Kohno Department of Surgery, National Sanatorium Higashi Utsunomiya Hospital 2160 Shimo-Okamoto, Kawachi-machi Kawachi-gun, 329-1193 JAPAN

Accepted
January 27, 1999

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