Document Detail


Control of alkaline reflux esophagitis after total gastrectomy by a percutaneous jejunostomy tube.
MedLine Citation:
PMID:  12080226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Postoperative alkaline reflux esophagitis is a potentially devastating complication after total gastrectomy. The advent of the Roux-en-Y reconstruction has significantly decreased the incidence of this complication. However, when reflux esophagitis occurs, it is often refractory to medical treatment. Even though surgical revision of the Roux-en-Y anastomosis is the management option of choice, affected patients (especially those with advanced metastatic cancers) are often poor surgical candidates. We describe a novel treatment of refractory alkaline reflux esophagitis in a patient after radical total gastrectomy with Roux-en-Y reconstruction for advanced gastric carcinoma. Radiologic placement of a percutaneous jejunostomy tube into the proximal jejunal limb resulted in significant symptomatic relief by external diversion of the pancreaticobiliary drainage, and the procedure was associated with minimal discomfort. Nonsurgical pancreaticobiliary diversion should be considered in those patients with refractory alkaline reflux esophagitis that occurs after total gastrectomy.
Authors:
Hwan Y Yoo; Anthony Venbrux; Richard Heitmiller; William J Ravich; Linda A Lee
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  35     ISSN:  0192-0790     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-06-24     Completed Date:  2002-08-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. hwanyoo@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Esophagitis, Peptic / etiology,  surgery*
Female
Gastrectomy / adverse effects*
Humans
Jejunostomy*
Middle Aged
Stomach Neoplasms / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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