A case of cancer arising on a multi-operated achalasic megaesophagus

The Authors report a case of acalasic megaoesophagus operated through extramucous myotomy according to Heller 20 years before coming to their observation and with relapse of disphagic symptoms due to serious oesophagitis during the subsequent years, in spite of an interposition of jejunal ansa according to Merendino and an oesophago-gastrostomy after removal of the interposed ansa. As the patient showed a further relapse of the disphagic symptoms, he, at last, underwent a subtotal oesophagectomy with intrathoracic oesophago-colon-plasty. At examination of the operative specimen, as a report added and not evidenced through the preoperative ascertainments, a limited oesophageal neoplastic degeneration at level of the oesophagogastro-stomy was found. The patient died one year and eight months after operation for neoplastic cachexia. The Authors analyse the causes determining the disphagic syndrome after surgical treatment of acalasic megaoesophagus, the therapeutical solutions suggested and the relations between megaoesophagus and oesophageal cancer.