A Case of Refractory Gastric Tube Ulcer with Surgical Staple in the Ulcer Floor

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  • 潰瘍底にｓｔａｐｌｅが認められた難治性胃管潰瘍の１例
  • 症例 潰瘍底にstapleが認められた難治性胃管潰瘍の1例
  • ショウレイ カイヨウテイ ニ staple ガ ミトメラレタ ナンチセイ イカン カイヨウ ノ 1レイ

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Abstract

A 71-year-old woman who had undergone an esophagectomy for benign esophageal stenosis reconstructed by gastric tube through the anterior portion of the sternum, and who had been on medication for lumbago with NSAIDs, was admitted to our hospital complaining of skin redness and oozing of blood in the anterior portion of the gastric tube. The skin redness and oozing of blood were caused by perforation of a gastric tube ulcer. The patient was treated by stoppage of the NSAIDs, eating restraint, hyperalimentation and proton pump inhibitor. The gastric tube ulcer gradually improved and the patient left the hospital. Two months later, however, the patient went into hospital again because of gastric tube ulcer perforation. The patient was treated by the same therapy with the first admission. The gastric tube ulcer gradually improved, but after the patient resumed eating, the gastric tube ulcer worsened. Infection of H. pylori was negative. Endoscopic examination revealed a surgical staple at the floor of the gastric tube ulcer. We diagnosed that the staple had caused the recurrence of the gastric tube ulcer, so we removed it. After that, the gastric tube ulcer improved swiftly and there has been no subsequent recurrence.

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