Penetration Into the Stomach

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Abstract
IN 1979, Angelchik and Cohen1,2described a prosthesis for the control of gastroesophageal reflux. It consists of a ring-shaped silicone elastomer shell filled with highly cross-linked silicone gel. The prosthesis is placed around the esophagus below the diaphragm and tied with a Dacron strap. We wish to report a complication of the device. Report of a Case In January 1982, a 72-year-old man came to our institution with intermittent dysphagia of three months' duration, which in the previous two weeks had progressed until he could swallow liquids only. In 1976, he had undergone a vagotomy, hemigastrectomy, and Billroth II anastomosis for a bleeding duodenal ulcer. In January 1981, he began to experience difficulties with nocturnal shortness of breath and paroxysmal coughing spells. The following April he was hospitalized at another institution for these symptoms with a diagnosis of "acute exacerbation of chronic obstructive pulmonary disease." During that hospitalization, he

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