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Adenocarcinoma in long-segment Barrett's esophagus 44 years after total gastrectomy.

Abstract
Although Barrett's esophagus may occur without gastric acid, Barrett's adenocarcinoma after total gastrectomy is rare. Here, we present Barrett's adenocarcinoma in long-segment Barrett's esophagus after total gastrectomy. The patient was a 74-year-old male who underwent total gastrectomy 44 years ago. An endoscopic examination revealed long-segment Barrett's esophagus starting 17 cm from the incisors and continuing 20 cm to esophagojejunostomy, with irregular mucosa 27-31 cm from the incisors. Pathological diagnosis of a biopsied specimen was adenocarcinoma. We performed subtotal esophagectomy with lymph node dissection in the prone position and reconstructed the esophagus with ileocolic interposition. Postoperative pathological diagnosis from a Barrett's epithelial section was well differentiated adenocarcinoma. This case had the longest interval from total gastrectomy and smallest oral margin of Barrett's epithelium. Our case suggested that careful surveillance is needed for patients exhibiting recurrent bile reflux following total gastrectomy.
AuthorsYutaka Shimada, Tomoyuki Okumura, Shozo Hojo, Koshi Matsui, Takuya Nagata, Shinichi Hayashi, Kenichi Tazawa, Fuminori Yamagishi, Kazuhiro Tsukada
JournalJournal of surgical case reports (J Surg Case Rep) Vol. 2013 Issue 12 (Dec 04 2013) ISSN: 2042-8812 [Print] England
PMID24968432 (Publication Type: Journal Article)
CopyrightPublished by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2013.

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