Esophageal ulcer related to zinc deficiency following a total gastrectomy

•Esophageal ulcers are caused by various reasons and 1% of patients with esophageal ulcers have unknown etiology.•We report the endoscopical and pathological charactrictics of multiple esophageal ulcer 4.5 y after gastrectomy.•The patient met the diagnostic criteria for zinc deficiency and the ulcers improved after zinc supplementation.•Zinc deficiency occurs commonly after gastrectomy.•We recommend that all patients undergoing gastrectomy should be carefully screened for zinc deficiency.