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Dysphagia following selective vagotomy.

S I Suleiman, S A Maglad, M Hobsley

    The British Journal of Surgery
    |September 1, 1979
    PubMed
    Summary
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    Severe esophageal obstruction after vagotomy is rare. This study presents the first case involving selective vagotomy without bouginage, successfully treated with surgery, offering new insights into managing post-vagotomy dysphagia.

    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Esophageal Diseases

    Background:

    • Vagotomy, a surgical procedure involving the vagus nerve, is used to reduce stomach acid production.
    • Progression of dysphagia to complete esophageal obstruction post-vagotomy is a rare but serious complication.
    • Previous cases involved truncal vagotomy and often required reoperation, with bouginage potentially worsening the condition.

    Observation:

    • This report details the first documented case of post-vagotomy esophageal obstruction following selective vagotomy.
    • The patient presented with dysphagia progressing to complete obstruction due to a fibrotic peri-esophageal collar.
    • Unlike previous reports, this patient did not undergo bouginage before surgical intervention.

    Findings:

    • Selective vagotomy, in contrast to truncal vagotomy, was performed in this patient.

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  • The absence of bouginage was a key difference in the management approach.
  • Surgical relief of the fibrotic collar successfully treated the complete esophageal obstruction.

    • Implications:

    • This case suggests that selective vagotomy may have a different complication profile regarding esophageal obstruction compared to truncal vagotomy.
    • Avoiding bouginage might be crucial in managing such rare fibrotic complications post-vagotomy.
    • Further research is warranted to understand the mechanisms and optimal management of post-vagotomy esophageal strictures.