Congenital duodenal membrane as cause for hiatus hernia, stricture of the oesophagus, and stricture carcinoma in an adult with Down's syndrome.

The case of a 31 year old male mongoloid patient is reported, where a congenital duodenal membrane, asymptomatic in childhood, had led to hiatal hernia, stricture of the oesophagus, and finally to carcinoma of the stricture (Fig. 1). Observation time until death was 26 months. In a first operation, the membrane was resected (Fig. 2) and Nissen's fundoplication performed. 31/2 months after that stricture, carcinoma was diagnosed. In the second operation, carcinoma was resected and continuity reestablished by oesophagogastrostomy. The patient died 8 months after the second intervention.