A Case of Esophageal Perforation of Ectopic Gastric Mucosa

Hideo Arima, Shoji Natsugoe, Masahiro Tokushige, Kanehiro Matsushita, Masataka Matsumoto, Hiroshi Okumura, Sumiya Ishigami, Shuichi Hokita and Takashi Aikou

First Department of Surgery, Kagoshima University School of Medicine

We present a case of ectopic gastric ulcer perforation of the esophagus. A 52-year-old man receiving medication for a duodenal ulcer experienced sudden epigastralgia and increased pain after serious vomiting. Based on highly suspicious for esophageal perforation, he was admitted. Barium study and computed tomography showed a perforation at the left side of the lower esophageal wall. Under a right thoracoabdominal approach, we conducted esophagectomy and esophagogastrostomy. Postoperatively, sepsis due to serious inflammation in the mediastinum occurred. He gradually recovered without anastomotic leakage or mediastinal abscess. In resected specimens, perforation of the ectopic gastric mucosa in the lower esophagus was found pathologically. No symptoms usually occur in ectopic gastric mucosa of the esophagus, and such lesions are found incidentally by endoscopy. We should thus be mindful of the risk of perforation and explain it to patients with such lesions.

Key words
esophagus, perforation, ectopic gastric mucosa

Reprint requests
Hideo Arima First Department of Surgery, Kagoshima University School of Medcine
8-35-1 Sakuragaoka, Kagoshima, 890-8520 JAPAN

Accepted
November 26, 2003

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