Abstract
A man in his 60s was admitted with an acute abdomen. Two years earlier, thoracic esophageal cancer was diagnosed (pT3N0M0 pStageII). He had an esophagectomy with reconstruction using a gastric tube via the posterior mediastinal route. At the same time, he received a jejunostomy for enteral alimentation. At the time of the present admission, he was diagnosed as having strangulation ileus due to the jejunostomy, as well as acute pancreatitis. Emergency laparotomy confirmed that the strangulation ileus was due to the jejunostomy and involved 400 cm of jejunum. As well, dilatation of the gastric tube, duodenum, and jejunum, along with redness and edema at the retroperitoneum around the pancreas were noted. The patient's jejunostomy was undone ; the patient reguiced peritoneal lavage and drainage. The patient recovered and was discharged on postoperative day 20. The efficacy of tube feeding with jejunostomy after esophagectomy is established ; however, the risk of ileus due to the jejunostomy should be recognized. This case highlights the potential difficulty of deciding to do a tube jejunostomy at the time of esophagectomy.
