Surgical treatment of recalcitrant radiation-induced gastric erosions

✍ Scribed by Yuk P. Yeung; Chiu M. Ho; Kam H. Wong; Kam H. Lam; Wing Y. Cheung; Anna W. M. Wong; Andrew W. C. Yip

• Book ID: 101246379
• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 55 KB
• Volume: 22
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/(sici)1097-0347(200005)22:3<303::aid-hed15>3.0.co;2-u

✦ Synopsis

Background. Uncontrolled bleeding as a result of radiation gastritis in patients who have pharyngo-laryngoesophagectomy and gastric pull-up is seldom reported. Surgical resection in the management of this condition has rarely been described.

Method. A 66-year-old man with hypopharyngeal cancer was treated by pharyngo-laryngo-esophagectomy and gastric transposition. He received postoperative radiotherapy and had recurrent hemorrhagic gastritis, necessitating surgical resection. The manubrium was resected to access the mediastinal part of the gastric conduit. The diseased part of the gastric conduit was removed and a free jejunal graft was interposed to replace the resected stomach.

Results. Manubrial resection offered adequate access to the stomach transposed in the mediastinum, and the life-threatening bleeding gastritis was successfully controlled by surgical resection.

Conclusion. Surgical resection of the radiation-damaged transposed stomach through a manubrial resection approach can safely be performed. Free jejunal graft is the choice of recon-struction of the circumferential defect.