Coexistence of the Megaoesophagus and Ankylosing Spondylitis - Case Report

• Authors: Andrzej Lewandowski , Małgorzata wyrobek , Michał geneja
• Languages of publication: EN

Abstracts

EN

Megaoesophgus is the result of the disorder of peristalsis and slow decompensation of muscular layer of the oesophagus in the course of cardiospasmus. It may coexist with systemic, infectious as well as endocrinological diseases. The operating treatment of megaoesophagus is difficult. The oesophagectomy with gastroplasty of short-segment colon or jejunum interposition are usually preceded.We presented a 53-years old man with megaoesophagus and ankylosing spondylitis, which was diagnosed on basis of clinical symptoms: the high values of the total proteins - 81 g/l, IgG - 21.48 g/l, and gamma-globulin - 30.8% as well as in radiological investigation. The dysphagia lasted over 20 years and led to oesophagus dilation and loss of motor function, as well as the ulcerations of the oesophagus, which was confirmed by X-ray examination and endoscopy. In this patient jejunal oesophago-gastric bypass was made. After a year and a half gastrectasis arose and gastrojejunal anstomosis was made in order to drian the stomach. After two and half years from the first operation decrease of the dilation of light of oesophagus and good passage by upper digestive tract was obtained and confirmed by X-ray examination. During endoscopical and histological investigation healing of ulcerations was found. Ambulatory follow-up and reumatological treatment is continued.

Keywords

EN

megaoesophagus; ankylosing spondylitis; surgical treatment

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2007
• Volume: 79
• Issue: 4
• Pages: 322-326

Dates

published

1 - 4 - 2007

online

17 - 10 - 2007

Contributors

author

Andrzej Lewandowski

• Department of Gastrointestinal and General Surgery, Medical University, Wroclaw

author

Małgorzata wyrobek

• Unit of Radiology, Mikulicz-Radecki University Hospital, Wrocław

author

Michał geneja

• Department of Gastrointestinal and General Surgery, Medical University, Wroclaw

References

• de Oliveira RB, Rezende Filho J, Dantas RO et al.: The spectrum of esophageal motor disorders in Chagas' disease. Am J Gastroenterol 1995; 90: 1119-24.
• Lovecek M, Duda M, Gryga A et al.: Manometry in esophageal achalasia. Rozhl Chir 2002; 81: 183-87.
• Park W, Vaezi MF: Etiology and pathogenesis of achalasia; the current understanding. Am J Gastroenterol 2005; 100: 1404-14.
• Patti MG, Gorodner MV, Galvani C et al.: Spectrum of esophageal motility disordes: implications and treatment. Arch Surg 2005; 140: 442-48.
• Pajecki D, Zilberstein B, dos Santos MA et al.: Megaesophagus microbiota: a qualitative and quantitative analysis. J Gastrointest Surg 2002; 6: 723-29.
• Fritzen R, Bornstein SR, Scherbaum WA: Megaoesophagus in a patient with autoimmune polyglandular syndrome type II. Clin Endocrinol 1996; 45: 493-98.
• Lopez-Cepero Andrada JM, Jimenez Arjona J, Amaya Vidal A et al.: Pseudoachalasia and secondary amyloidosis in a patient with rheumatoid arthritis. Gastroenterol Hepatol 2002; 25: 398-400.
• Gockel I, Eckardt VF, Roth W et al.: Dolichomegaesophagus in achalasia. Therapy by esophogectomy in an aged patient. Dtsch Med Wochenschr 2004; 129: 735-38.
• Lewandowski A: Sposoby operacyjnego leczenia nienowotworowych schorzeń dolnego odcinka przewodu pokarmowego w aspekcie odtwarzania funkcji zaporowej wpustu. Rozprawa habilitacyjna, AM Wrocław 1994; 51-53: 57-61.
• Georgescu S, Tarcoveanu E: Current treatment of esophageal achalasia. Surgeons' opinion. Rev Med Chir Soc Med Nat Iasi 2002; 106: 702-04.

Identifiers

DOI

10.2478/v10035-007-0049-z