December 1962

Terminal Esophageal (Vestibular) Spasm After Vagotomy

Author Affiliations

From the Gastroenterology Section of the Medical Service and the Surgical Service, Veterans Administration Hospital.

Arch Surg. 1962;85(6):955-968. doi:10.1001/archsurg.1962.01310060091018

Vagotomy, as a surgical approach to the treatment of peptic ulcer disease, was first described by Exner and Schwarzmann in 1912,1 but it has been primarily as a result of the more recent work of Dragstedt2,3 that this procedure has gained increasingly widespread acceptance.

The occurrence of achalasia of the esophagus as a complication of vagotomy has received scant mention in the accumulating literature on this subject.4-8 Although this condition occurs most uniformly after cervical or high intrathoracic section of the vagus nerves in dogs,9 it has only rarely been encountered after vagus section in man. Dragstedt attributes this to the fact that the vagi are usually divided only a short distance above the hiatus and has postulated that damage to the vagus nerves higher up might produce spasm of the cardia in man as it does in the lower animals. Ivy,10 in discussing vagotomy,

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