Abstract
We report a case of suture line ulcer in the interposed jejunal pouch which arose 8 years and 9 months after surgery, and this is the first case. A 40-year-old man underwent a lower esaphagectomy and a proximal gastrectomy for giant leiomyoma in the esophagogastric junction in March 1997. Reconstruction was performed by interposition of a jejunal pouch. The postoperative course was uneventful, but the patient visited our department because of severe epigastric pain on November 27, 2005. An emergency endoscopy examination revealed a white mossy and deep ulcer in the posterior wall of jejunal pouch interposition. Abdominal pain disappeared after about 3 days by oral administration of proton pump inhibitor.
Healing of the tumor proceeded steadily, however, parts of the silk suture were found to have been exposed. Seven months after occurrence of the condition, the silk thread disappeared. The ulcer was consequently completely healed. This silk thread was used in jejunal pouch interposition formation to make the sero-muscular layer suture, which reinforced the area sutured and severed by linear cutter GIA. The ulcer is believed to have been caused by the suture line.
