A SURGICAL CASE OF REFLUX ESOPHAGITIS COMPLICATED WITH ESOPHAGEAL STRICTURE AFTER OPERATION FOR PERFORATIVE PERITONITIS INDUCED BY DUODENAL ULCER

A 71-year-old woman progressively developed esophageal stricture during a follow-up observation of reflux esophagitis after operation for duodenal ulcer-induced perforative peritonitis. The patient was treated first by baloon dilatation, but, as perforation of the esophagus developed, another operation by the procedure used for achalasia was performed after closing the perforated site of the esophagus. She is recovering favorably under good condition of oral feeding. This case suggests that esophageal stricture associated with reflux esophagitis may be induced not only by dysfunction of protective factors such as esophagus, lower esophageal sphincter, but by excess of attacking factors. Also suggested by this case is that fundoplication applied to achalasia is useful in some cases of reflux esophagitis complicated with esophageal stricture but without hiatal hernia.