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1 Polish Journal of Surgery

1 2007

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Coexistence of the Megaoesophagus and Ankylosing Spondylitis - Case Report

100%

Lewandowski A. , wyrobek M. , geneja M.

2007

tom 79

nr 4

322-326

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.