To the Editor.—Gastroesophagoplasty remains the most widely used method of reconstruction after esophagectomy of the middle third of the esophagus. To our knowledge, we describe a previously unreported complication of this operation.
Report of a Case.—A 55-year-old man had severe hematemesis and malena. Seven months previously, he had undergone an esophagectomy and gastroesophagoplasty for a squamous cell carcinoma of the middle third of the esophagus which was followed by radiotherapy. The patient's condition deteriorated rapidly despite massive blood transfusions, and immediate laparotomy was performed. The abdominal portion of the stomach was found to be severely inflamed at gastrotomy, but the thoracic portion was not well visualized. The abdomen was closed but the patient died before any further surgery could be considered.
Postmortem Findings.—A gastric ulcer, 5 cm in diameter, was found in the thoracic portion of the stomach. This communicated with the thoracic aorta by means of