Utility of transjejunostomal endoscopy following bypass surgery for refractory esophageal ulceration after thoracic aortic aneurysm operation in a patient with Marfan’s syndrome

• Published in: Esophagus : official journal of the Japan Esophageal Society Vol. 12; no. 1; pp. 73 - 76
• Main Authors: Kubota, Keisuke, Okada, Akihiro, Kuroda, Junko, Yoshida, Masashi, Horiguchi, Yuta, Origuchi, Nobuto, Obitsu, Yukio, Kitajima, Masaki
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.01.2015; Springer Nature B.V
• Subjects: Aortic aneurysms; Case Report; Case reports; Endoscopy; Esophagus; Gastroenterology; Heart surgery; Medicine; Medicine & Public Health; Ostomy; Stents; Surgical Oncology; Thoracic Surgery; Bypass surgery; Transjejunostomal endoscopy; Marfan’s syndrome; Thoracic aortic aneurysm; Refractory esophageal ulceration
• ISSN: 1612-9059; 1612-9067
• DOI: 10.1007/s10388-013-0406-4

Refractory esophageal ulcerations occur rarely after cardiovascular surgery, occasionally leading to perforation. There is little consensus on their optimal management. Herein, we present a case of refractory esophageal ulceration after cardiovascular surgery. A 62-year-old woman with Marfan’s syndrome was referred to our hospital with cardiac failure due to aortic regurgitation. She underwent root replacement by the modified Bentall method. Refractory esophageal ulceration developed 3 months later and persisted for 3 months despite conservative therapy. With the patient’s informed consent, Kirschner bypass surgery was performed. A jejunostomy using a 20 Fr. Nelaton catheter was made in the Roux-en-Y loop of the jejunum for postoperative endoscopy. The postoperative course was uneventful and transjejunostomal endoscopy revealed excellent healing of the ulceration. Esophageal bypass surgery and transjejunostomal endoscopy were very effective in this patient with refractory esophageal ulceration.