Korswagen Lindy-Anne, Schrama Jolanda G, Bruins Slot Warner, Hunfeld Michiel A J M
Department of Internal Medicine, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands.
Obes Surg. 2009 Mar;19(3):389-92. doi: 10.1007/s11695-008-9718-1. Epub 2008 Oct 8.
A 43-year-old man presented with severe back pain. He had a history of morbid obesity, for which an esophagogastric silicone band was placed 2 years before presentation. Magnetic resonance imaging of the vertebral column showed multiple osseous metastases. On the computerized tomography scan of the abdomen, a tumor of the lower esophagus just proximal to the esophagogastric band was seen, of which histological examination revealed an esophageal adenocarcinoma. Esophageal adenocarcinoma after bariatric surgery has been described previously in only a few cases. Although there is no evidence for a causal relationship with bariatric surgery, one should bear in mind that the incidence of esophageal adenocarcinoma is increased in patients with morbid obesity because of the higher incidence of gastroesophageal reflux disease. Also, the symptoms of adenocarcinoma might be masked after bariatric surgery.
一名43岁男性因严重背痛就诊。他有病态肥胖史,在就诊前2年放置了食管胃硅酮带。脊柱磁共振成像显示多处骨转移。腹部计算机断层扫描显示,在食管胃带近端的下食管有一个肿瘤,组织学检查显示为食管腺癌。减肥手术后发生食管腺癌此前仅在少数病例中有描述。虽然没有证据表明与减肥手术存在因果关系,但应记住,由于胃食管反流病的发病率较高,病态肥胖患者食管腺癌的发病率会增加。此外,减肥手术后腺癌的症状可能会被掩盖。