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A case of secondary achalasia caused by scar tissue formation after distal gastrectomy

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Abstract

A 64-year-old man underwent distal gastrectomy for gastric cancer. His postoperative recovery was uneventful until he suddenly started complaining of difficulty swallowing. Fluoroscopy revealed narrowing of the abdominal esophagus into a spindle-like shape. Endoscopic esophageal balloon dilatation was performed with no improvement in his condition. We concluded that the patient could not eat because of mechanical stenosis of the gastroesophageal junction. Reoperation was performed via laparotomy. The abdominal esophagus and gastroesophageal junction were found to have become stiff with adhesions, probably as a result of surgical scarring. We incised the esophageal muscle layer and dissected adhesions around the abdominal esophagus to relieve esophageal stenosis. After reoperation, the patient was able to eat. We recommend that in cases of sudden onset dysphagia after distal gastrectomy, the possibility of secondary achalasia because of scar tissue formation should be considered.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Digestive Surgery, Kawasaki Medical School, Matsushima, Kurashiki, 701-0192, Japan

    Haruaki Murakami, Hideo Matsumoto, Hisako Kubota, Masaharu Higashida, Masafumi Nakamura & Toshihiro Hirai

  2. Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan

    Noriaki Manabe

  3. Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Kurashiki, Japan

    Ken Haruma

Authors
  1. Haruaki Murakami
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  2. Hideo Matsumoto
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  3. Hisako Kubota
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  4. Masaharu Higashida
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  5. Masafumi Nakamura
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  6. Noriaki Manabe
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  7. Ken Haruma
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  8. Toshihiro Hirai
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Correspondence to Haruaki Murakami.

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Murakami, H., Matsumoto, H., Kubota, H. et al. A case of secondary achalasia caused by scar tissue formation after distal gastrectomy. Esophagus 10, 118–122 (2013). https://doi.org/10.1007/s10388-012-0357-1

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  • DOI: https://doi.org/10.1007/s10388-012-0357-1

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