A 41-year-old woman with total gastrectomy with Roux-en-Y reconstruction because she had poorly differentiated gastric adenocarcinoma 2 years earlier.
Chemotherapy was associated with cisplatin and iridotecán, and 12 cycles were administered.
He required salvage surgery 18 months after the first surgery for local recurrence extra localostomy: thermolateral anastomosis with new Roux-en-Y reconstruction and subtotal colectomy with terminolateral ileocolic anastomosis.
Peritoneal, colon, intestinal loop and esophageal rim of resection were observed in the surgical specimen.
She was referred to the Gastroenterology Department due to progressive dysphagia two months after surgery, accompanied by weight loss.
Esophageal stricture was performed in which distal esophageal stenosis was observed. Subsequently, an upper endoscopy was performed: distal esophageal stenosis with normal mucosa, with negative biopsies for malignancy; suture stitches and surgical staples were also found.
The suture stitches were removed and 6 sessions of pneumatic dilatation were performed, being ineffective.
Disphagia was suspected when a transmural effusion was suspected and a non-recovered esophageal prosthesis was placed. Expanding the expansion of the prosthesis allowed the visualization of the prosthesis in 7 cm.
At 48 hours he was able to take a soft diet and showed a clear improvement of his dysphagia.
The patient has received associated cycles of palliative chemotherapy.
Eight months after stent placement, dysphagia and weight loss appeared again.
Endoscopy showed growth of the neoplasm through the prosthesis ; it was decided to place a recombined esophageal prosthesis 10 cm long.
The patient resumes oral feeding, improving her dysphagia.
She died 6 months later due to systemic tumor invasion.
