Surgical aspects of multifocal involvement of the gastrointestinal tract in progressive systemic sclerosis.

An operative approach to the problem of progressive systemic scleroderma, affecting both the esophagus and duodenum, is demonstrated in the case of a 38-year-old woman severely incapacitated by protracted vomiting. Nissen's fundoplication, antrectomy and Billroth II gastroenterostomy were performed. The need for a comprehensive balanced surgical therapeutic approach in patients suffering from scleroderma is emphasized.