Surgical aspects of multifocal involvement of the gastrointestinal tract in progressive systemic sclerosis.

: An operative approach to the problem of progressive systemic scleroderma, affecting both the esophagus and duodenum, is demonstrated in the case of a 38-year-old woman severely incapacitated by protracted vomiting. Nissen's fundoplication, antrectomy and Billroth II gastroenterostomy were performed. The need for a comprehensive balanced surgical therapeutic approach in patients suffering from scleroderma is emphasized.