Persistent Dyspepsia Due to Dysphagia Aortica Successfully Treated with the Laparoscopic Approach

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  • 下行大動脈による食道通過障害（dysphagia aortica）に対し腹腔鏡下修復術が有効であった1例

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Abstract

A 75-year-old man with a 4-year history of dysphagia was admitted to our hospital, and had experienced a weight loss of 11 kg during that period. On gastrointestinal manometry examination, peristaltic motility of the esophagus was not observed. On the basis of the findings from gastrointestinal contrast radiography, gastrointestinal endoscopy, and CT, we diagnosed the patient’s condition as esophageal passage disorder due to compression of the descending aorta (dysphagia aortica). Since the patient’s symptoms did not improve after dietary counseling, surgical repair was planned. By using the laparoscopic approach, the esophageal hiatus was completely exposed. We exfoliated approximately 8 cm in length of the esophagus in the lower mediastinum; the tortuous esophagus was mobilized and straightened; and Toupet’s fundoplication was performed. A fundic wrap was fixed to both sides of the esophageal hiatus. The operation lasted 151 min, and blood loss was 30 ml. No complications occurred after the operation. Passage disorder improved during the early postoperative period, and the patient was discharged on the seventh postoperative day. Twenty-two months after the operation, no symptoms accompanied with passage disorder recurred, and the patient gained 5 kg in weight.

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