Iuliu Hatieganu University of Medicine and Pharmacy, Cluj, Romania, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: The adenocarcinoma of esophagogastric junction includes three anatomical
entities which have in common parietal extension and lymphatic dissemination both to the mediastinum
and abdomen. Due to the dramatically increasing incidence, Siewert & Stein described and classified
the disease as a tumor located 5 cm above and under the anatomical cardia, in order to lead to an optimal
surgical treatment.
Clinical case: A 71 years old male presented to C.F. Cluj- Napoca Hospital complaining about
progressive dysphagia, loss of appetite, postprandial regurgitation with fetid halitosis. In association, the
patient presented fatigability and weight loss (4-5 kg in the last 3 months).
The patient history reveals the existence of multiple cardiac pathology, such as atrial fibrillation,
atrioventricular block grade III, right bundle branch block, aortic regurgitation grade II and mitral
regurgitation grade II.
The results of the paraclinical tests lead us to the following diagnosis: adenocarcinoma of
esophagogastric junction type II Siewert- Stein, pT4N1M1. Taking into account the cardiac pathology,
the optimal treatment in this case is a gastrostomy.
Conclusion: The particularity of the case consists in choosing the most appropriate surgical
therapy considering the advanced stage of the tumor and the Associated comorbidities
