Can a jejunal loop offer more resistance to acidity?
When loss of anti-reflux function between the esophagus and the stomach occurs from destruction of the distal esophagus by ulceration, fibrosis or perforation, the ability to construct a competent valve surgically (Nissen, Hill or Belsey), is lost. In these cases, interposition reproduces a structure that prevents reflux acid burn of the distal esophagus. Human colon and jejunal segments are available. In my opinion, based on the literature and my own experience, the jejunal loop will offer a uniquely better resistance to esophageal acidity if properly interposed between the esophagus and the stomach. The basis for this rests on anatomic, radiographic and physiologic phenomena.
KeywordsAcidity Barium Histamine Perforation Esophagitis
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