1995 Volume 56 Issue 5 Pages 976-979
A 71-year-old man was seen at the hospital because of epigastralgia after a 5-year uneventful postoperative course. In 1986 the patient was diagnosed as having a lu esophageal cancer and underwent total resection of the intrathoracic esophagus with esophageal replacement via the retrosternal route by means of a gastric tube and pyloroplasty. This time an upper gastrointestinal series and endoscopic examination revealed two A2 stage peptic ulcers on the anterior wall and posterior wall of the lower part of the gastric tube respectively. He had not have any habitual use of non-steroidal anti-inflammatory drugs. The Gastogram of the gastric tube showed the rapid empty pattern. The serum gastrin value was high. The good acidity of the gastric tube was revealed by the acid analysis, 24 hours gastric tube pH-monitor and the endoscopic Congo-Reddye test. The gastric mucosal prostaglandin E2 value was high. Although H2-blocker was not effective, there was a clinical and endoscopical improvement with H+-inhibitor. We presum that in this csase, the peptic ulcers in a gastric tube were caused by losing the balance of the offense and deffense factors due to an incerse of the offense factor.
