Esohageal Resection and Reconstruction

Dear Sir or Madam:

My father underwent surgery for esophageal cancer back in May.  The surgery went as expected not complication while on the table however his recovery has not been so kind.  He developed bi-lateral pneumonia and became septic after the infections passed; he was having difficulty with items passing from his stomach to his intestine from his J-Tube.  Come to find out his pylorus was not allowing liquids to drain so a stent was put in.  After about 2.5 weeks of the stent in, he started vomiting blood.  He was taken to ER and they found a blood clot had fully incased the stent and would not let things pass.  The stent was removed however there was no sign of ulcerations around or under the stent.  It is unknown where the blood actually came from.  At this point, my father is at home however his quality of life is diminished due to the fact that he is always nauseated and occasionally vomits, however the vomiting does not actually bring much up other than bile at times.    

My question is, has there been cases where patients who have had esophageal cancer and the resection and reconstruction of their esophagus live in constant states of nausea?  Is there any cure or relief?  He is currently on Marinol and was on the strongest anti-nausea medication available however it doesn't seem to stop.   Any information would be helpful. Thank you.

[Denise L. Johnson, M.D.]

This situation sounds very unfortunate for your father. I do not know what type of reconstruction your father had, however, it sounds as though his stomach is not emptying.  Other possibilities are a stricture at the suture line or again at the pylorus.

Please sit down with your father's surgeon and ask the following questions:

1) Was the tumor completely removed?
2) What stage was the tumor ?
3) Need for additional chemotherapy or radiation
4) Need for an upper GI or Barium swallow?
5) Need for a swallowing study?

You did not give the age of your father, his other medical problems, but you have to have a long discussion with the surgery doctors and get your questions answered.
HOpe this helps.

Dr. J

[lisawaters]

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