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Two cases of esophageal ulcer after surgical treatment for ulcerative colitis


The incidence of postoperative esophageal ulcers has been rarely reported associated with severe ulcerative colitis (UC). We report two cases of esophageal ulcers accompanied by acute necrotizing esophagitis after undergoing surgery for severe UC. Both patients, 47- and 53-year-old, were diagnosed with severe UC and underwent subtotal colectomy with sigmoid mucous fistula and ileostomy. In both cases, they had epigastralgia or digestive track bleeding and upper gastrointestinal endoscopy revealed an esophageal ulcer with acute necrotizing esophagitis accompanied by a black degeneration of mucosa after surgery. Conservative treatments improved the lesions. Esophageal stricture requiring endoscopic dilatation occurred in both cases. An acute UC requiring surgery seems to warrant caution in the merger of esophageal ulcer and acute necrotizing esophagitis.

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Data availability

Not applicable.



Ulcerative colitis


5-Aminosalicylic acid






Subtotal colectomy with a sigmoid mucous fistula and ileostomy


Endoscopic balloon dilatation


Disseminated intravascular coagulation


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The authors thank Enago ( for the English language review. The authors also thank Angela Morben, DVM, ELS, from Edanz Group (, for editing a draft of this manuscript.


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HK prepared the draft of the report and collected the data. AS, KK, KT, RF, and KA collected the data. AS and KK edited the manuscript and supervised the study. All authors reviewed and revised the report. All authors read and approved the final manuscript.

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Correspondence to Hirosuke Kuroki.

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The authors declare that they have no competing interests.

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The study protocol was approved by the Ethical Review Board for Clinical Studies at Yokohama Municipal Citizen’s Hospital (control number 19-02-04).

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Written informed consent was obtained from the patient for the publication of this case report and any accompanying images.

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Kuroki, H., Sugita, A., Koganei, K. et al. Two cases of esophageal ulcer after surgical treatment for ulcerative colitis. Clin J Gastroenterol 13, 495–500 (2020).

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  • Ulcerative colitis
  • Surgery
  • Esophageal ulcer
  • Acute necrotizing esophagitis