Abstract
A 75-year-old man with esophageal cancer underwent subtotal esophagectomy with gastric tube reconstruction and three-field lymph node dissection after two courses of docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy. Recurrence developed in his mediastinal lymph nodes one and a half years post operation. The patient was re-admitted for additional DCF treatment and enteral nutritional support. A high fever exceeding 39°C with an inflammatory reaction developed six days after starting naso-gastric tube feeding. A computed tomography (CT) scan revealed portal venous gas and submucosal emphysema in the reconstructed gastric tube, and emphysematous gastritis was suspected. The feeding tube was removed and antibiotic treatment started. One week after starting treatment, the gastric tube emphysema and portal venous gas resolved along with improvements in the inflammatory signs. To our knowledge, this is the first report of emphysematous gastritis developing in the reconstructed gastric tube after esophagectomy. Early diagnosis and treatment appears to be crucial for this critical disease.
