Dysphagia following selective vagotomy

Progression of dysphagia after vagotomy to the stage of complete obstruction due to a peri-oesophageal fibrotic collar needing operation is a rare event. Review of the 4 such cases previously described, all needing further operation and all after truncal vagotomy, indicates that the oesophageal mucosa was normal on oesophagoscopy and that bouginage appeared to make the condition worse. This paper describes the first patient in whom (a) the vagotomy was selective and (b) no bouginage was carried out before the condition was relieved by a further surgical operation.