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January 24, 1977

Bronchial Carcinoma With Autovagotomy and Bezoar Formation

JAMA. 1977;237(4):364-365. doi:10.1001/jama.1977.03270310048008

AUTOVAGOTOMY, except as a manifestation of diabetic autonomic neuropathy, is a rare occurrence. Esophageal carcinoma causing autovagotomy and gastric bezoar has been recorded.1 The present communication concerns the association of bronchial carcinoma with autovagotomy, gastric outlet obstruction, and bezoar formation.

Report of a Case  A 54-year-old man was hospitalized for recurrent pneumonia of the left side. During the previous six months he had experienced dysphagia, hemoptysis, anorexia, and an 18-kg weight loss. A chest roentgenogram showed a persistent infiltrate in the lingula and the superior segment of the left lower lobe. Bronchial cytology and biopsy specimens showed atypical squamous metaplasia. An upper gastrointestinal tract x-ray film showed a midesophageal stricture caused by an extrinsic lesion (Fig 1), an atonic stomach with gastric outlet obstruction, and a large intragastric mass simulating an extensive fundal carcinoma (Fig 2). A second film, taken after carbon dioxide producing tablets had been ingested to