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Rana P, Sheth M, Deshpande S, Dikshit A, Patel S, Patel D, Garachh M. Serpentine pulmonary arteries supplying the lung isthmus in horseshoe lung: A rare cause of esophageal compression. Pediatr Pulmonol 2024; 59:1473-1475. [PMID: 38265151 DOI: 10.1002/ppul.26885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/31/2023] [Accepted: 01/14/2024] [Indexed: 01/25/2024]
Affiliation(s)
- Pratyaksha Rana
- Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India
| | - Megha Sheth
- Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India
| | - Saurabh Deshpande
- Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India
| | - Archit Dikshit
- Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India
| | - Samir Patel
- Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India
| | - Dinesh Patel
- Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India
| | - Milin Garachh
- Department of Radiology, U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India
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2
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Mackus L, Masche A, Höpfner R, Schmerbach K. [Esophageal stenosis as a result of a right aortic arch in 2 cats]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2024; 52:117-124. [PMID: 38701807 DOI: 10.1055/a-2289-1234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
A 3-month-old and a 4-year-old cat were presented in the clinic due to regurgitation. The kitten had displayed the symptoms since it had been fed solid foods and was smaller than the litter mates. The 4-year-old cat showed sudden-onset symptoms for 5 days prior to presentation and had a good general condition. Positive contrast thoracic radiographs of both cats in lateral recumbency showed an esophageal dilatation cranial to the heart base and raised a suspicion of foreign material with soft tissue density in this area. In the 4-year-old cat, findings of ventrodorsal thoracic radiographs were compatible with a dextroposition of the aorta and a slightly marked focal left curve of the trachea. The echocardiographic examination of the kitten pictured a right sided aorta, hence a vascular ring anomaly with a dextroposition from the aorta was suspected. Aberrant blood flow as it is seen in a persistent ductus arteriosus was not apparent in the echocardiography. As a result of the sudden development of the clinical signs in the older cat without displaying any former history of regurgitation, an esophagoscopy was performed to exclude an intraluminal esophageal cause for the stricture as well as to extract the foreign material. In this cat, computed tomography imaging also displayed an aberrant left subclavian artery. Both cats recovered well after surgical correction.The diagnosis of a ring anomaly in the kitten via echocardiography is a rare situation. As is the diagnosis of a high-grade esophageal stricture due to a vascular ring anomaly at the age of 4 without a former history of regurgitation.Recovery was excellent in the younger cat. There were no signs of regurgitation 6 months after surgery. The adult cat was in good general condition without clinical symptoms according to the owners when presented for stitch removal. Unfortunately, the adult cat was lost to follow up.
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Affiliation(s)
- Lena Mackus
- Kleintierspezialisten, Dres. Schmerbach & Höpfner GmbH, Berlin
| | - Anja Masche
- Kleintierspezialisten, Dres. Schmerbach & Höpfner GmbH, Berlin
| | - Robert Höpfner
- Kleintierspezialisten, Dres. Schmerbach & Höpfner GmbH, Berlin
| | - Kay Schmerbach
- Kleintierspezialisten, Dres. Schmerbach & Höpfner GmbH, Berlin
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3
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Chae Y, Yun T, Koo Y, Lee D, Lee Y, Chang D, Yang M, Kang B, Kim H. Oesophageal stricture in a cat with true pleuroperitoneal hernia. Vet Med Sci 2024; 10:e1392. [PMID: 38389312 PMCID: PMC10884558 DOI: 10.1002/vms3.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/05/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
A 2-year-old neutered male Bengal cat presented with solid food dysphagia and chronic regurgitation for >5 months. There were no clinical abnormalities on haematological or radiographic examinations. Thoracic radiography revealed a soft tissue opacity mass adjacent to the diaphragm in the caudoventral thorax. Ultrasonography revealed a protruding liver lobe surrounded by a hyperechoic lining from the diaphragm towards the thorax, and a pleuroperitoneal hernia was diagnosed. An endoscopy was performed to examine the cause of regurgitation, and an oesophageal stricture was observed. Endoscopic balloon dilation of the oesophageal stricture was performed, and the regurgitation was resolved immediately. However, regurgitation relapsed 2 months later, and computed tomography was performed to ascertain the cause. Computed tomography revealed oesophageal mural thickening and true pleuroperitoneal hernia with partial liver lobe herniation. A second endoscopy with balloon dilation was performed to treat the relapsing oesophageal stricture, and the clinical signs resolved without the need for herniorrhaphy. Nevertheless, oesophageal stricture could occur due to gastroesophageal reflux related to a pleuroperitoneal hernia; however, a definite link could not be elucidated in this case. This report describes a case of oesophageal stricture and concurrent true pleuroperitoneal hernia in a cat.
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Affiliation(s)
- Yeon Chae
- Laboratory of Veterinary Internal MedicineCollege of Veterinary MedicineChungbuk National UniversityCheongjuChungbukRepublic of Korea
| | - Taesik Yun
- Laboratory of Veterinary Internal MedicineCollege of Veterinary MedicineChungbuk National UniversityCheongjuChungbukRepublic of Korea
| | - Yoonhoi Koo
- College of Veterinary MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Dohee Lee
- Laboratory of Veterinary Internal MedicineCollege of Veterinary MedicineChungbuk National UniversityCheongjuChungbukRepublic of Korea
| | - Yelim Lee
- Laboratory of Veterinary Internal MedicineCollege of Veterinary MedicineChungbuk National UniversityCheongjuChungbukRepublic of Korea
| | - Dongwoo Chang
- Department of Veterinary ImagingVeterinary Teaching HospitalCollege of Veterinary MedicineChungbuk National UniversityCheongjuChungbukRepublic of Korea
| | - Mhan‐Pyo Yang
- Laboratory of Veterinary Internal MedicineCollege of Veterinary MedicineChungbuk National UniversityCheongjuChungbukRepublic of Korea
| | - Byeong‐Teck Kang
- Laboratory of Veterinary Internal MedicineCollege of Veterinary MedicineChungbuk National UniversityCheongjuChungbukRepublic of Korea
| | - Hakhyun Kim
- Laboratory of Veterinary Internal MedicineCollege of Veterinary MedicineChungbuk National UniversityCheongjuChungbukRepublic of Korea
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4
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唐 运, 魏 绪, 薛 宁, 徐 俊. [Endoscopic ultrasonography features of benign esophageal stenosis in children]. Zhongguo Dang Dai Er Ke Za Zhi 2024; 26:169-173. [PMID: 38436315 PMCID: PMC10921870 DOI: 10.7499/j.issn.1008-8830.2309045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/25/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVES To investigate the endoscopic ultrasonography (EUS) features of benign esophageal stenosis in children. METHODS A retrospective analysis was conducted on the medical data of the children who were diagnosed with benign esophageal stenosis from February 2019 to February 2022. The clinical manifestations, EUS findings, and treatment outcome were analyzed to summarize the EUS features of benign esophageal stenosis in children. RESULTS A total of 42 children with benign esophageal stenosis were included. Among these children, 19 (45%) had anastomotic stenosis after surgery for esophageal atresia, with unclear echogenic boundary of the esophageal walls and uneven thicknesses of the surrounding wall on EUS, and had 0-12 sessions of endoscopic treatment (average 2.1 sessions); 5 children (12%) had corrosive esophageal stenosis and 1 child (2%) had physical esophageal stenosis, with unclear stratification of the esophageal walls on EUS, and they had 2-9 sessions of endoscopic treatment (average 5.3 sessions); 1 child (2%) had patchy irregular hypoechoic areas of the esophageal walls on EUS and was diagnosed with tracheobronchial remnants with reference to pathology; 16 children (38%) had unexplained esophageal stenosis and unclear stratification of the esophageal walls on EUS, among whom 6 received endoscopic treatment. During follow-up, 95% (40/42) of the children had significant alleviation of the symptoms such as vomiting and dysphagia. CONCLUSIONS For benign esophageal stenosis in children, EUS can help to evaluate the degree of esophageal wall involvement in esophageal stenosis lesions, possible etiologies, and the relationship between the esophagus and the lesion and provide an important basis for selecting treatment modality and avoiding complications, thereby helping to optimize the treatment regimen.
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Affiliation(s)
- 运萍 唐
- 山东省儿童健康与疾病临床医学研究中心,山东济南250022
| | - 绪霞 魏
- 山东省儿童健康与疾病临床医学研究中心,山东济南250022
| | - 宁 薛
- 山东省儿童健康与疾病临床医学研究中心,山东济南250022
| | - 俊杰 徐
- 山东省儿童健康与疾病临床医学研究中心,山东济南250022
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5
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Chalasani A, Chetwood JD, Leong R, Paramsothy S. Gastrointestinal: A discovery hard to swallow: an unusual case of esophageal obstruction. J Gastroenterol Hepatol 2024; 39:219. [PMID: 37675467 DOI: 10.1111/jgh.16351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/25/2023] [Accepted: 08/26/2023] [Indexed: 09/08/2023]
Affiliation(s)
- A Chalasani
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - J D Chetwood
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - R Leong
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine Health and Human Science, Macquarie University, Sydney, New South Wales, Australia
| | - S Paramsothy
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine Health and Human Science, Macquarie University, Sydney, New South Wales, Australia
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Pham A, Ezzeddine L, Bonnard A, Lapillonne A, Rousseau V, Montalva L, Khattat N, Guilbert J, Mokhtari M, Fouquet V, Jaby O, Decobert F, Mitanchez D, Ducou Le Pointe H, Irtan S. Usefulness of routine early œsophagogram after primary repair of œsophageal atresia: a multicenter study. Pediatr Res 2023; 94:1779-1783. [PMID: 37328687 DOI: 10.1038/s41390-023-02696-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/05/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Advances in surgical and neonatal care have led to improved survival of patients with œsophageal atresia (OA) over time. Morbidity remains significant, with one-third of patients being affected by a postoperative complication. Several aspects of management are not consensual, such as the use of œsophagogram before starting oral feeding. METHODS We conducted a multicenter retrospective study, including all children with OA that underwent a primary anastomosis in the first days of life, between 2012 and 2018 in five French centers, to determine the usefulness of postoperative œsophagogram during the 10 days after early primary repair of OA to diagnose the anastomotic leak and congenital œsophageal stenosis. RESULTS Among 225 included children, 90 (40%) had a routine œsophagogram and 25 (11%) had an anastomotic leak, clinically diagnosed before the scheduled œsophagogram in 24/25 (96%) children at median postoperative day 4. Ten patients had associated congenital œsophageal stenosis diagnosed on the œsophagogram in only 30% of cases. CONCLUSION Early œsophagogram is rarely useful in the diagnosis of an anastomotic leak, which is clinically diagnosed before performing an œsophagogram in the majority of cases. The need for a postoperative œsophagogram should be evaluated on a case-by-case basis. IMPACT Early œsophagogram is not helpful in the diagnosis of an anastomotic leak in the majority of cases. An anastomotic leak is most often diagnosed clinically before performing an œsophagogram. Early postoperative œsophagogram could be helpful for the diagnosis of congenital œsophageal stenosis. However, dysphagia occurs later and early diagnosis of congenital œsophageal stenosis has no impact on the management and outcome of asymptomatic children. Indication of postoperative œsophagogram has to be evaluated on a case-by-case basis.
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Affiliation(s)
- Aurélie Pham
- Sorbonne University, Assistance publique des hôpitaux de Paris, Armand Trousseau Hospital, Department of Neonatal Medicine, 75012, Paris, France.
| | - Lynn Ezzeddine
- Sorbonne University, Assistance publique des hôpitaux de Paris, Armand Trousseau Hospital, Department of Pediatric Radiology, 75012, Paris, France
| | - Arnaud Bonnard
- Paris-Cité University, Assistance publique des hôpitaux de Paris, Robert-Debré University Hospital, Department of Pediatric General Surgery and Urology, 75019, Paris, France
| | - Alexandre Lapillonne
- Paris-Cité University, Assistance publique des hôpitaux de Paris, Necker-Enfants Malades University Hospital, Neonatal Intensive Care Unit, 75015, Paris, France
| | - Véronique Rousseau
- Paris-Cité University, Assistance publique des hôpitaux de Paris, Necker-Enfants Malades University Hospital, Department of Pediatric Surgery, 75015, Paris, France
| | - Louise Montalva
- Paris-Cité University, Assistance publique des hôpitaux de Paris, Robert-Debré University Hospital, Department of Pediatric General Surgery and Urology, 75019, Paris, France
| | - Nizar Khattat
- Paris-Cité University, Assistance publique des hôpitaux de Paris, Robert-Debré University Hospital, Neonatal Intensive care unit, 75019, Paris, France
| | - Julia Guilbert
- Sorbonne University, Assistance publique des hôpitaux de Paris, Armand Trousseau Hospital, Intensive neonatal and pediatric care unit, 75012, Paris, France
| | - Mostafa Mokhtari
- Paris Saclay University, Assistance publique des hôpitaux de Paris, Kremlin Bicêtre Hospital, Neonatal Intensive care unit, 94250, Le Kremlin Bicêtre, France
| | - Virginie Fouquet
- Paris Saclay University, Assistance publique des hôpitaux de Paris, Kremlin Bicêtre Hospital, Department of Pediatric Surgery, 94250, Le Kremlin Bicêtre, France
| | - Olivier Jaby
- Centre hospitalier intercommunal de Créteil, Department of Pediatric Surgery, 94300, Créteil, France
| | - Fabrice Decobert
- Centre hospitalier intercommunal de Créteil, Neonatal Intensive Care Unit, 94300, Créteil, France
| | - Delphine Mitanchez
- François Rabelais University, CHRU de Tours, Bretonneau Hospital, Neonatal Intensive Care Unit, 37000, Tours, France
| | - Hubert Ducou Le Pointe
- Sorbonne University, Assistance publique des hôpitaux de Paris, Armand Trousseau Hospital, Department of Pediatric Radiology, 75012, Paris, France
| | - Sabine Irtan
- Sorbonne University, Assistance publique des hôpitaux de Paris, Armand Trousseau Hospital, Department of visceral and neonatal pediatric surgery, 75012, Paris, France
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Bush N, Bhattacharjee S, Sachan A, Gupta R, Rana S. Perforations from Endoscopic Dilation of Corrosive Strictures in Adults: A Systematic Review and Meta-Analysis. Dig Dis Sci 2022; 67:3200-3209. [PMID: 34739625 DOI: 10.1007/s10620-021-07295-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/08/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIMS Endoscopic dilation is an important therapeutic option for treatment of corrosive strictures. Its safety is unclear with variable perforation rates in previous studies. We aimed to evaluate its safety with regard to perforations and the effect of dilator type to perforation risk. METHODS A systematic review of published literature from inception to April 24, 2021, using PubMed and EMBASE databases was conducted. Studies in adult subjects (mean age ≥ 18 years) reporting perforation rates of endoscopic dilation of corrosive esophageal and/or gastric strictures were included. Pooled cumulative perforation rates were computed as primary outcome. Secondary outcomes included, perforation with each dilator subtypes, surgical or conservative modes of management and mortality. Random effect meta-analysis was used to estimate the frequency of each of these outcomes. Variables were reported as percentages with 95% CI. RESULTS A total of 712 subjects (N) who underwent 4840 dilations (n) were noted in the 15 studies that were included. Of which, eight were retrospective, while the remaining seven were prospective. On meta-analysis, the cumulative pooled perforation rate was 1% (1-2%) of the number of dilations (n%). The perforation rates with SG (1%, 0-3%) and balloon (1%, 0-5%) dilators were similar (p value < 0.01). 45/64 (59%, 11-94%) perforations were subjected to surgery while the remaining 14/64 (41%, 6-89%) was managed conservatively. Choice of management strategy was biased to the norms of the treating team. About 3/712 patients (0%, 0-2%) succumbed following perforation. CONCLUSION Perforation from endoscopic dilation of corrosive strictures occurs rarely, and there is no significant difference in perforation risk related to the type of dilator.
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Affiliation(s)
- Nikhil Bush
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Samiksha Bhattacharjee
- Department of Clinical Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Anurag Sachan
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Rajesh Gupta
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Surinder Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
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Daoud ND, Ghoz H, Mzaik O, Zaver HB, McKinney M, Brahmbhatt B, Woodward T. Endoscopic Management of Luminal Strictures: Beyond Dilation. Dig Dis Sci 2022; 67:1480-1499. [PMID: 35212884 DOI: 10.1007/s10620-022-07396-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 12/19/2022]
Abstract
Luminal strictures can occur as part of many different gastrointestinal (GI) disorders anywhere along the GI tract and affect all age groups. The end goal of managing any stricture is to re-establish an adequate and durable luminal patency that is sufficient to resolve the presenting clinical symptoms. Treatment options can be generally categorized into medical, endoscopic, and surgical. However, within each of these categories, multiple different options are available. Therefore, choosing the best treatment modality is often challenging and depends on multiple factors including the type, location, and complexity of the stricture, as well as the preference of the treating physician. In this article, we will review the most current literature regarding foregut strictures, particularly esophageal and gastric, beyond dilation.
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Affiliation(s)
- Nader D Daoud
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Hassan Ghoz
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Obaie Mzaik
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Himesh B Zaver
- Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Micah McKinney
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Bhaumik Brahmbhatt
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
| | - Timothy Woodward
- Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
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Tanaka E, Oda N, Kobayashi S, Ogawa T, Mitani R, Nawa T, Takata I, Ueki T, Okada H. Mediastinal Lymph Node Metastasis of Esophageal Cancer with Esophageal Stenosis Diagnosed via Transesophageal Endoscopic Ultrasound with Bronchoscope-guided Fine-needle Aspiration. Intern Med 2022; 61:1007-1010. [PMID: 34511572 PMCID: PMC9038477 DOI: 10.2169/internalmedicine.8214-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
An 80-year-old man underwent follow-up examinations after endoscopic submucosal dissection (ESD) for esophageal cancer. Computed tomography showed enlarged lymph nodes of the right recurrent nerve. The patient had esophageal stenosis due to repeated ESD for multiple esophageal tumors. The stenosis made the passage of an endoscopic ultrasound (EUS) scope through the esophagus difficult. Thus, an endobronchial ultrasound bronchoscope, which had a thinner diameter than that of the EUS scope, was used for transesophageal endoscopic ultrasound with bronchoscope-guided fine-needle aspiration. This technique led to the diagnosis of mediastinal lymph node metastasis of esophageal cancer.
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Affiliation(s)
- Emi Tanaka
- Department of Internal Medicine, Fukuyama City Hospital, Japan
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Naohiro Oda
- Department of Internal Medicine, Fukuyama City Hospital, Japan
| | - Sayo Kobayashi
- Department of Internal Medicine, Fukuyama City Hospital, Japan
| | | | - Reo Mitani
- Department of Internal Medicine, Fukuyama City Hospital, Japan
| | - Toru Nawa
- Department of Internal Medicine, Fukuyama City Hospital, Japan
| | - Ichiro Takata
- Department of Internal Medicine, Fukuyama City Hospital, Japan
| | - Toru Ueki
- Department of Internal Medicine, Fukuyama City Hospital, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
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Xu Z, Huang T, Pan M, Huang Y, Jiang Y. Case Report: Recessive Dystrophic Epidermolysis Bullosa With Severe Esophageal Stenosis: A Case Report and Literature Review. Br J Biomed Sci 2022; 79:10200. [PMID: 35996499 PMCID: PMC9302543 DOI: 10.3389/bjbs.2022.10200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/28/2022] [Indexed: 12/04/2022]
Affiliation(s)
- Zhen Xu
- Deparment of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tianqiao Huang
- Deparment of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Min Pan
- Deparment of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yichuan Huang
- Deparment of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yan Jiang
- Deparment of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Yan Jiang,
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Navarro P, Laserna-Mendieta EJ, Guagnozzi D, Casabona S, Perelló A, Savarino E, de la Riva S, Olalla JM, Ghisa M, Serrano-Moya N, Alcolea-Valero C, Ortega-Rabbione G, Majano P, Santander C, Arias Á, Lucendo AJ. Proton pump inhibitor therapy reverses endoscopic features of fibrosis in eosinophilic esophagitis. Dig Liver Dis 2021; 53:1479-1485. [PMID: 34120859 DOI: 10.1016/j.dld.2021.05.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/15/2021] [Accepted: 05/14/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Long-standing inflammation leads to esophageal remodeling with stricture formation in patients with eosinophilic esophagitis (EoE). The ability of proton pump inhibitors (PPI) to reverse endoscopic features of fibrosis is still unknown. OBJECTIVE To investigate the effect of a short course of PPI treatment in reducing endoscopic findings indicative of esophageal fibrosis in EoE patients. METHODS Cross-sectional analysis of the EoE CONNECT registry. Patients who received PPI to induce EoE remission were evaluated. Endoscopic features were graded using the EoE Endoscopic Reference Score (EREFS), with rings and strictures indicating fibrosis. Results were compared to those from patients treated with swallowed topic corticosteroids (STC). RESULTS Clinico-histological remission was achieved in 83/166 adult patients treated with PPI (50%) and in 65/79 (82%) treated with STC; among responders, 60 (36%) and 57 (72%) patients respectively achieved deep histological remission (<5 eosinophils/hpf). At baseline, mean±SD EREFS was lower in patients treated with PPI compared to those who received STC (p < 0.001). Short term treatment significantly reduced EREFS scores in patients treated either with PPI or STC as well as rings and strictures. Among patients treated with PPI, deep histological remission (<5 eosinophils/hpf) provided further reduction in total EREFS score. CONCLUSION Effective PPI therapy for EoE significantly reduced endoscopic esophageal fibrosis in the short term.
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Affiliation(s)
- Pilar Navarro
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
| | - Emilio J Laserna-Mendieta
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain; Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Clinical Laboratory, Hospital Universitario de La Princesa, Madrid, Spain
| | - Danila Guagnozzi
- Department of Gastroenterology, Hospital Universitario Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Sergio Casabona
- Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Department of Gastroenterology, Hospital Universitario La Princesa, Madrid, Spain
| | - Antonia Perelló
- Department of Gastroenterology, Hospital de Viladecans, Barcelona, Spain
| | - Edoardo Savarino
- Department of Surgery, Oncology and Gastroenterology, Università di Padova, Padova, Italy
| | | | - José María Olalla
- Department of Gastroenterology Clinica Universidad de Navarra, Pamplona, Spain
| | - Matteo Ghisa
- Department of Surgery, Oncology and Gastroenterology, Università di Padova, Padova, Italy
| | | | | | - Guillermo Ortega-Rabbione
- Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Data Analysis Unit, Health Research Institute Hospital Universitario de la Princesa, Madrid, Spain
| | - Pedro Majano
- Research Unit, Hospital Universitario La Princesa, Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Cecilio Santander
- Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain; Department of Gastroenterology, Hospital Universitario La Princesa, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ángel Arias
- Research Unit, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad. Real, Spain; Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain; Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
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Dzidzava Z, Giorgobiani M, Tsuleiskiri I, Zenaishvili B, Mosidze E. COMPARATIVE ASSESSMENT OF RISK-BENEFIT RATIO OF USE OF SILICONE BOUGIE VERSUS ALTERNATIVE METHODS IN POSTOPERATIVE MANAGEMENT OF ESOPHAGEAL ATRESIA. Georgian Med News 2021:27-30. [PMID: 34511439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The aim of the present research is to assess the beneficial and adverse effects of silicone bougie use in comparison to alternative methods of post-operative management of esophageal atresia. The study was carried on 28 patients treated at our healthcare institution for esophageal atresia during the period from May, 2017 to September, 2020. As an alternative to the use of esophageal bougie these patients were managed postoperatively, by utilizing the contrast imaging of the esophagus on the 7th and 14th days after surgery, and at the age of 1, 3, 6 months and one year. Unless the esophageal stricture has developed, the procedures are repeated annually until the age of 5. The aim of utilizing the contrast imaging technique is to prevent the stricture of the esophagus and recurrence of trachea esophageal fistula.
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Affiliation(s)
- Z Dzidzava
- Pediatric Privat Clinic, Tbilisi, Georgia
| | | | | | | | - E Mosidze
- Pediatric Privat Clinic, Tbilisi, Georgia
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13
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Koklu H, Vahabov C, Parlak E, Kav T. Choledochoscope-assisted antegrade-retrograde endoscopic dilation of complete esophageal stenosis in a patient with dystrophic epidermolysis bullosa. Acta Gastroenterol Belg 2020; 83:491-492. [PMID: 33094601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Dystrophic epidermolysis bullosa is a mucocutaneous disorder, characterized by recurrent formation of blisters and scarring. The gastrointestinal tract is commonly affected by the disease and the proximal esophagus is the most common area of involvement of the gastrointestinal tract. The esophageal strictures are common in patients with dystrophic epidermolysis bullosa that can lead to complete esophageal stenosis in some cases. The antegrade/retrograde endoscopic dilation is a commonly used method in these patients. Different kinds of endoscopes may be used for the retrograde procedure, such as conventional upper gastrointestinal (UGI) endoscopes, slim-paediatric UGI endoscopes and ultrathin UGI nasal endoscopes. Herein, we reported the first antegrade/retrograde esophageal dilation case performed under choledochoscopic guidance.
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Affiliation(s)
- H Koklu
- Hacettepe University School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Ankara, Turkey
| | - C Vahabov
- Hacettepe University School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Ankara, Turkey
| | - E Parlak
- Hacettepe University School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Ankara, Turkey
| | - T Kav
- Hacettepe University School of Medicine, Department of Internal Medicine, Division of Gastroenterology, Ankara, Turkey
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14
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Ali O, Asumu H, Kaur T, Mathew A, Kim R. A rare cause of dysphagia due to esophageal intramural pseudodiverticulosis: a case report and review of literature. BMC Gastroenterol 2020; 20:72. [PMID: 32178627 PMCID: PMC7074979 DOI: 10.1186/s12876-020-01209-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 02/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Esophageal intramural pseudodiverticulosis is an uncommon, idiopathic disorder characterized by multiple small outpouchings protruding from the esophageal lumen. Esophageal intramural pseudodiverticulosis is associated with conditions such as gastroesophageal reflux disease and diabetes mellitus, as well as emergent complications including pneumomediastinum. The most common presenting symptom is dysphagia with associated esophageal stricture formation. While the pathogenesis of EIP has yet to be determined, it is important to bring awareness to this unique disease with distinctive diagnostic findings and treatment options. CASE PRESENTATION In this case, we present a 62-year-old woman who suffered from dysphagia, an inability to tolerate a regular diet, and unintentional weight loss for several years prior to her diagnoses. She was diagnosed by esophagram and esophagogastroduodenoscopy to have esophageal intramural pseudodiverticulosis, complicated by severe stricture formation. Following treatment with sequential dilatation and maintenance H2-blocker therapy, she achieved significant symptomatic improvement. CONCLUSIONS This case highlights the importance of accurate identification and treatment of an uncommon cause of dysphagia, esophageal intramural pseudodiverticulosis. Treatment includes dilatational therapy, as successfully demonstrated in our patient. Furthermore, treatment is focused on optimizing medical management, as demonstrated in our patient with the addition of an H2-blocker for GERD, or addressing potentially serious underlying causes, such as carcinoma, with surgery.
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Affiliation(s)
- Osman Ali
- Department of Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA
| | - Hazel Asumu
- Department of Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA
| | - Tanisha Kaur
- Department of Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA
| | - Angelina Mathew
- Department of Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA
| | - Raymond Kim
- Department of Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA.
- Department of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
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15
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Backer CL. Vascular Rings With Tracheoesophageal Compression: Management Considerations. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2020; 23:48-52. [PMID: 32354547 DOI: 10.1053/j.pcsu.2020.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/16/2020] [Accepted: 02/03/2020] [Indexed: 06/11/2023]
Abstract
Our series of vascular ring patients treated at Ann & Robert H. Lurie Children's Hospital of Chicago has now exceeded 450 patients (see Central Picture). The recommendations from this review are based on our experience with those patients. Since 1990, we have used preoperative cross-sectional imaging in all vascular ring patients. This has led us to refine our operative strategies and carefully tailor the operation to the individual's unique anatomy. In particular for right aortic arch patients, we now address the Kommerell diverticulum in most cases and carefully consider Kommerell diverticulum resection with left subclavian artery transfer. In double aortic arch patients, we also look for a Kommerell diverticulum and resect the diverticulum if present. This will decrease the number of patients presenting for a reoperation after initial vascular ring surgery. Since 1947, we have operated on 217 patients with a right aortic arch. The median age is 1.5 years. Since 2006, 47 out of 111 patients have had Kommerell diverticulum resection and left subclavian artery transfer to the left carotid artery. Mean length of stay is 4.5 days. In the same time period, 187 patients have been treated for a double aortic arch. The median age is 1 year. Twelve of these patients also had resection of a Kommerell diverticulum. The mean length of stay in this group was 3 days. Advanced preoperative cross-sectional imaging leads to precise operative techniques tailored to the unique anatomy of each vascular ring patient.
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Affiliation(s)
- Carl L Backer
- Division of Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, A.C. Buehler Professor of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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16
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Eskander A, Ghobrial C, Mohsen NA, Mounir B, Abd EL-Kareem D, Tarek S, El-Shabrawi MHF. Histopathological changes in the oesophageal mucosa in Egyptian children with corrosive strictures: A single-centre vast experience. World J Gastroenterol 2019; 25:870-879. [PMID: 30809086 PMCID: PMC6385009 DOI: 10.3748/wjg.v25.i7.870] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/17/2019] [Accepted: 01/26/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The caustic ingestion continues to be a major problem worldwide especially in developing countries. The long-term complications include stricture and increased life time risk of oesophageal carcinoma. Patients suffered from corrosive induced oesophageal strictures have more than a 1000-fold risk of developing carcinoma of the oesophagus.
AIM To determine the possibility of oesophageal mucosal dysplasia after prolonged dilatation in post corrosive stricture.
METHODS This observational study was conducted at the Paediatric Endoscopy Unit in Cairo University Children’s Hospital. It included children of both sexes older than 2 years of age who had an established diagnosis of post-corrosive oesophageal stricture and repeated endoscopic dilatation sessions for more than 6 mo. All patients were biopsied at the stricture site after 6 mo of endoscopic dilatation. A histopathological examination of an oesophageal mucosal biopsy was performed for the detection of chronic oesophagitis, inflammatory cellular infiltration and dysplasia.
RESULTS The mean age of the enrolled children was 5.9 ± 2.6 years; 90% of the patients had ingested an alkaline corrosive substance (potash). The total number of endoscopic dilatation sessions were ranging from 16 to 100 with mean number of sessions was 37.2 ± 14.9. Histopathological examination of the specimens showed that 85% of patients had evidence of chronic oesophagitis (group A) in the form of basal cell hyperplasia, hyperkeratosis and subepithelial fibrosis. Thirteen percent of the patients had evidence of reactive atypia (group B) in the form of severe neutrophilic intraepithelial inflammatory cellular infiltration, and 2 patients (2%) had mild squamous dysplasia (group C); we rebiopsied these two patients 6 mo after the initial pathological assessment, guided by chromoendoscopy by Lugol's iodine.
CONCLUSION The histopathology of oesophageal mucosal biopsies in post-corrosive patients demonstrates evidence of chronic oesophagitis, intraepithelial inflammatory cellular infiltration and dysplasia. Dysplasia is one of the complications of post-corrosive oesophageal stricture.
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Affiliation(s)
- Ayman Eskander
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Carolyne Ghobrial
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Nabil A Mohsen
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Bahaa Mounir
- Department of Pathology, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Dalia Abd EL-Kareem
- Department of Pathology, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Sara Tarek
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Mortada HF El-Shabrawi
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
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17
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Struyve M, Langemans C, Robaeys G. Pneumomediastinum as a complication of esophageal intramural pseudodiverticulosis. Acta Gastroenterol Belg 2018; 81:433-435. [PMID: 30350535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Dysphagia is a common complaint of patients seen at the outpatient clinic as well as at the emergency room. We report esophageal intramural pseudodiverticulosis (EIPD) as a cause of dysphagia that is less known by physicians and it is rarely described in the literature. EIPD is characterized by multiple, segmental or diffuse, flask-like outpouchings in the esophageal wall corresponding to dilated and inflamed excretory ducts of the submucosal esophageal glands. The underlying etiology remains unclear. Esophageal strictures, esophageal candidiasis and gastroesophageal reflux disease are often associated. The diagnosis can be made by upper gastrointestinal endoscopy, but barium esophagography is the modality of choice. Complications of EIPD are rare and include broncho-esophageal and esophagomediastinal fistula, pleural and pericardial effusion, abscesses, gastrointestinal bleeding from a web-like stenosis or esophageal perforation with pneumomediastinum. The treatment for EIPD should be directed towards treating underlying associated conditions and relieving symptoms rather than the pseudodiverticulosis itself.
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Affiliation(s)
- M Struyve
- Department of Gastroenterology, University Hospitals Gasthuisberg, Leuven, Belgium
- Department of Gastroenterology, Ziekenhuis Oost-Limburg (ZOL), Genk, Belgium
| | - C Langemans
- Department of Gastroenterology, Ziekenhuis Oost-Limburg (ZOL), Genk, Belgium
- Department of Internal Medicine, University Hospitals Gasthuisberg, Leuven, Belgium
| | - G Robaeys
- Department of Gastroenterology, University Hospitals Gasthuisberg, Leuven, Belgium
- Department of Gastroenterology, Ziekenhuis Oost-Limburg (ZOL), Genk, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
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18
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Boyko V, Savvi S, Korolevska A, Zhydetskyy V, Novikov Y, Bytiak S, Shuba D. SURGICAL TREATMENT OF BENING ESOPHAGEAL STRICTURES AFTER CORROSIVE INJURIES. Georgian Med News 2018:7-15. [PMID: 29905537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The research is based on the results of the examination and treatment of 156 patients who received treatment for extended benign esophageal strictures after corrosive injuries in the department of diseases of the esophagus and the gastrointestinal tract of the State Institution "V. T. Zaitsev Institute of General and Urgent Surgery of NAMS of Ukraine" for the period from 2000 to 2016. Surgical treatment by the developed in our hospital technique performed in the patients of the main group and the classical methods of surgery were used in the patients of comparison group. The developed in our clinic method of one-step transhital esophagogastroplasty with formation of a single anastomosis on the neck in patients with extended benign esophageal strictures after corrosive injuries in the state of compensation and subcompensation can be considered as a method of choice. Adequate preoperative verification of the type of extended damage by the cicatricial process of the upper part of digestive tract and the impossibility of eating in a natural way in the acute postburn period, as well as significant nutritive disorders in patients, provide the basis for two-step surgical treatment. This approach involves formation of gastrostomy at the first step for the restoration of trophological status of the patient and esophagoplasty at the second step. The two-step surgical treatment of patients with extended benign esophageal strictures after corrosive injuries with the formation of contact gastrostomy at first step and the implementation of esophagogastroplasty on the second step promotes improvement of treatment outcomes and life quality of the operated patients.
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Affiliation(s)
- V Boyko
- 1State Institution "V. T. Zaitsev Institute of General and Urgent Surger of National Academy of Medical Sciences of Ukraine", Kharkiv; 2Kharkiv National Medical University; 3V.N. Karazin Kharkiv National University, Ukraine
| | - S Savvi
- 1State Institution "V. T. Zaitsev Institute of General and Urgent Surger of National Academy of Medical Sciences of Ukraine", Kharkiv; 2Kharkiv National Medical University; 3V.N. Karazin Kharkiv National University, Ukraine
| | - A Korolevska
- 1State Institution "V. T. Zaitsev Institute of General and Urgent Surger of National Academy of Medical Sciences of Ukraine", Kharkiv; 2Kharkiv National Medical University; 3V.N. Karazin Kharkiv National University, Ukraine
| | - V Zhydetskyy
- 1State Institution "V. T. Zaitsev Institute of General and Urgent Surger of National Academy of Medical Sciences of Ukraine", Kharkiv; 2Kharkiv National Medical University; 3V.N. Karazin Kharkiv National University, Ukraine
| | - Y Novikov
- 1State Institution "V. T. Zaitsev Institute of General and Urgent Surger of National Academy of Medical Sciences of Ukraine", Kharkiv; 2Kharkiv National Medical University; 3V.N. Karazin Kharkiv National University, Ukraine
| | - S Bytiak
- 1State Institution "V. T. Zaitsev Institute of General and Urgent Surger of National Academy of Medical Sciences of Ukraine", Kharkiv; 2Kharkiv National Medical University; 3V.N. Karazin Kharkiv National University, Ukraine
| | - D Shuba
- 1State Institution "V. T. Zaitsev Institute of General and Urgent Surger of National Academy of Medical Sciences of Ukraine", Kharkiv; 2Kharkiv National Medical University; 3V.N. Karazin Kharkiv National University, Ukraine
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19
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Abstract
The role of fibreoptic endoscopy in the investigation of dysphagia in an elderly population was investigated. Three hundred and sixty-five subjects were studied. Two hundred and sixty subjects had abnormalities with extra oesophageal disease accounting for symptoms in a substantial minority. Endoscopy was safe, offered the advantage of immediate therapy and was well tolerated. Sub-group analysis showed it to be preferable to radiological investigation in diagnosing both benign and malignant mucosal lesions.
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Affiliation(s)
- P Bannister
- Department of Geriatrics & Medicine, Bristol Royal Infirmary
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20
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Kim JW, Kim TH, Kim JH, Lee IJ. Predictors of post-treatment stenosis in cervical esophageal cancer undergoing high-dose radiotherapy. World J Gastroenterol 2018; 24:862-869. [PMID: 29467556 PMCID: PMC5807944 DOI: 10.3748/wjg.v24.i7.862] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 12/25/2017] [Accepted: 01/16/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate toxicity and treatment outcome of high-dose radiotherapy (RT) for cervical esophageal cancer (CEC).
METHODS We reviewed a total of 62 consecutive patients who received definitive RT for stage I to III cervical esophageal cancer between 2001 and 2015. Patients who received < 45 Gy, treated for lesions below sternal notch, treated with palliative aim, treated with subsequent surgical resection, or diagnosed with synchronous hypopharyngeal cancer were excluded. Treatment failures were divided into local (occurring within the RT field), outfield-esophageal, and regional [occurring in regional lymph node(s)] failures. Factors predictive of esophageal stenosis requiring endoscopic dilation were analyzed.
RESULTS Grade 1, 2, and 3 esophagitis occurred in 19 (30.6%), 39 (62.9%), and 4 patients (6.5%), respectively, without grade ≥ 4 toxicities. Sixteen patients (25.8%) developed post-RT stenosis, of which 7 cases (43.8%) were malignant. Four patients (6.5%) developed tracheoesophageal fistula (TEF), of which 3 (75%) cases were malignant. Factors significantly correlated with post-RT stenosis were stage T3/4 (P = 0.001), complete circumference involvement (P < 0.0001), stenosis at diagnosis (P = 0.024), and endoscopic complete response (P = 0.017) in univariate analysis, while complete circumference involvement was significant in multivariate analysis (P = 0.003). A higher dose (≥ 60 Gy) was not associated with occurrence of post-RT stenosis or TEF. With a median follow-up of 24.3 (range, 3.4-152) mo, the 2 y local control, outfield esophageal control, progression-free survival, and overall survival (OS) rates were 78.9%, 90.2%, 49.6%, and 57.3%, respectively. Factors significantly correlated with OS were complete circumference involvement (P = 0.023), stenosis at diagnosis (P < 0.0001), and occurrence of post-RT stenosis or TEF (P < 0.001) in univariate analysis, while stenosis at diagnosis (P = 0.004) and occurrence of post-RT stenosis or TEF (P = 0.023) were significant in multivariate analysis.
CONCLUSION Chemoradiation for CEC was well tolerated, and a higher dose was not associated with stenosis. Patients with complete circumferential involvement require close follow-up.
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Affiliation(s)
- Jun Won Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, South Korea
| | - Tae Hyung Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, South Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, South Korea
| | - Ik Jae Lee
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, South Korea
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21
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Osuga T, Ikura Y, Hasegawa K, Hirano S. Use of endoscopic balloon dilation for benign esophageal stenosis in children: our 11 year experience. Esophagus 2018; 15:47-51. [PMID: 29892808 DOI: 10.1007/s10388-017-0595-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 10/30/2017] [Indexed: 02/03/2023]
Abstract
Endoscopic balloon dilation (EBD) is an established therapy for esophageal stenosis. To assess its usefulness in children, we reviewed 11 years of pediatric cases of EBD in our hospital. Over the last 11 years, EBD was performed on 14 pediatric patients (10 boys and four girls; 7 months-11 years) at our hospital. All EBD sessions were performed under general anesthesia and fluoroscopic monitoring. The sessions were repeated every week or alternate weeks until resolution of dysphagia or development of smooth endoscope passage. Stenosis was resolved in 14 of 14 patients (100%). None of the patients (0%) showed recurrence of stenosis. As for postoperative complications, mediastinitis occurred only in one patient (7.1%). The median number of session repeats for an individual patient was three (range 1-10). EBD is a safe and effective therapeutic modality for esophageal stenosis in children.
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Affiliation(s)
- Tatsuya Osuga
- Department of Gastroenterology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki, 569-1192, Japan.
| | - Yoshihiro Ikura
- Department of Pathology, Takatsuki General Hospital, Takatsuki, Japan
| | - Kazunori Hasegawa
- Department of Gastroenterology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki, 569-1192, Japan
| | - Seiichi Hirano
- Department of Gastroenterology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki, 569-1192, Japan
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22
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Affiliation(s)
- Tun Hing Lui
- Department of orthopaedics and traumatology, North District Hospital, Hong Kong, China
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23
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Abstract
Corrosive ingestion is a rare but potentially devastating event and, despite the availability of effective preventive public health strategies, injuries continue to occur. Most clinicians have limited personal experience and rely on guidelines; however, uncertainty persists about best clinical practice. Ingestions range from mild cases with no injury to severe cases with full thickness necrosis of the oesophagus and stomach. CT scan is superior to traditional endoscopy for stratification of patients to emergency resection or observation. Oesophageal stricture is a common consequence of ingestion and newer stents show some promise; however, the place of endoscopic stenting for corrosive strictures is yet to be defined. We summarise the evidence to provide a plan for managing these potentially life-threatening injuries and discuss the areas where further research is required to improve outcomes.
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Affiliation(s)
- Mircea Chirica
- Department of Digestive and Emergency Surgery, University Hospital of Grenoble, Grenoble Alpes University, Grenoble, France.
| | - Luigi Bonavina
- University of Milan Medical School, Division of General Surgery, IRCCS Policlinico San Donato, Milan, Italy
| | - Michael D Kelly
- Acute Surgical Unit, Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Emile Sarfati
- Department of Digestive and Endocrine Surgery, Saint-Louis Hospital AP-HP, Université Paris Diderot Sorbonne Paris Cité, Paris, France
| | - Pierre Cattan
- Department of Digestive and Endocrine Surgery, Saint-Louis Hospital AP-HP, Université Paris Diderot Sorbonne Paris Cité, Paris, France
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24
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Kim KY, Tsauo J, Song HY, Park JH, Jun EJ, Zhou WZ, Kim MT. Evaluation of a New Esophageal Stent for the Treatment of Malignant and Benign Esophageal Strictures. Cardiovasc Intervent Radiol 2017; 40:1576-1585. [PMID: 28516274 DOI: 10.1007/s00270-017-1677-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 04/28/2017] [Indexed: 01/15/2023]
Affiliation(s)
- Kun Yung Kim
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
| | - Jiaywei Tsauo
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
| | - Ho-Young Song
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea.
| | - Jung-Hoon Park
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
- Biomedical Engineering Center, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Songpa-Gu, Seoul, 138-736, Republic of Korea
| | - Eun Jung Jun
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
| | - Wei-Zhong Zhou
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Min Tae Kim
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
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Moorthy N, Ananthakrishna R, Rao DPV, Hegde M, Nanjappa MC. Right Aortic Arch With Left-Sided Arteria Lusoria: A Challenge for Radial Interventionalists. JACC Cardiovasc Interv 2017; 10:e85-e86. [PMID: 28412259 DOI: 10.1016/j.jcin.2017.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 02/06/2017] [Accepted: 02/09/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Nagaraja Moorthy
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
| | - Rajiv Ananthakrishna
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
| | - Dattatreya P V Rao
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
| | - Madhav Hegde
- Department of Radiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
| | - Manjunath C Nanjappa
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
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26
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Yoneyama F, Sato F, Tokunaga C, Sakamoto H, Enomoto Y, Watanabe Y, Hiramatsu Y. Postoperative Dysphagia in Debranching Thoracic Endovascular Aortic Repair with Retroesophageal Carotid-Carotid Bypass. Ann Vasc Surg 2017; 43:315.e1-315.e4. [PMID: 28479429 DOI: 10.1016/j.avsg.2017.01.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/15/2016] [Accepted: 01/12/2017] [Indexed: 11/18/2022]
Abstract
A carotid-carotid bypass is commonly used in debranching thoracic endovascular aortic repair. When the bypass graft is placed in the retroesophageal position, the esophagus may be compressed by the graft from behind. Therefore, dysphagia may occur postoperatively as a serious complication. To avoid this issue, we recommend placing the bypass graft below the cricoid cartilage.
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Affiliation(s)
- Fumiya Yoneyama
- Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | - Fujio Sato
- Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Chiho Tokunaga
- Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroaki Sakamoto
- Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yoshiharu Enomoto
- Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yutaka Watanabe
- Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yuji Hiramatsu
- Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Abstract
Purpose: The purpose was to investigate the manometric characteristics in patients with lower esophageal rings or strictures with special reference to food impaction. Material and Methods: The material comprised 344 patients (158 female and 186 male). Lower esophageal rings or strictures were diagnosed radiologically by the full column technique. Manometry was performed with triple lumen catheters connected to a hydraulic capillary system and external transducers. Results: Forty patients had rings, and 21 patients strictures. The reference group comprised 283 patients. Dysphagia was seen most frequently in patients with rings. Food impaction was seen only in patients with rings or strictures, whereas chest pain and heartburn appeared with the same incidence in all 3 groups. Non-specific motor disorders were seen most frequently in patients with strictures, but as delayed esophageal emptying with no influence on the tendency to food impaction. Only ring diameter, but not stricture diameter, was of any significance with a higher incidence of food impaction in patients with narrow rings. Conclusion: Radiology rather than manometry should be the first diagnostic step in patients with benign dysphagia suffering from food impaction.
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Affiliation(s)
- L Røhl
- Department of Radiology R, Aarhus University Hospital, Denmark
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28
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Bertolini R, Meyenberger C, Putora PM, Albrecht F, Broglie MA, Stoeckli SJ, Sulz MC. Endoscopic dilation of complete oesophageal obstructions with a combined antegrade-retrograde rendezvous technique. World J Gastroenterol 2016; 22:2366-2372. [PMID: 26900299 PMCID: PMC4735011 DOI: 10.3748/wjg.v22.i7.2366] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/03/2015] [Accepted: 12/08/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the combined antegrade-retrograde endoscopic rendezvous technique for complete oesophageal obstruction and the swallowing outcome.
METHODS: This single-centre case series includes consecutive patients who were unable to swallow due to complete oesophageal obstruction and underwent combined antegrade-retrograde endoscopic dilation (CARD) within the last 10 years. The patients’ demographic characteristics, clinical parameters, endoscopic therapy, adverse events, and outcomes were obtained retrospectively. Technical success was defined as effective restoration of oesophageal patency. Swallowing success was defined as either percutaneous endoscopic gastrostomy (PEG)-tube independency and/or relevant improvement of oral food intake, as assessed by the functional oral intake scale (FOIS) (≥ level 3).
RESULTS: The cohort consisted of six patients [five males; mean age 71 years (range, 54-74)]. All but one patient had undergone radiotherapy for head and neck or oesophageal cancer. Technical success was achieved in five out of six patients. After discharge, repeated dilations were performed in all five patients. During follow-up (median 27 mo, range, 2-115), three patients remained PEG-tube dependent. Three of four patients achieved relevant improvement of swallowing (two patients: FOIS 6, one patient: FOIS 7). One patient developed mediastinal emphysema following CARD, without a need for surgery.
CONCLUSION: The CARD technique is safe and a viable alternative to high-risk blind antegrade dilation in patients with complete proximal oesophageal obstruction. Although only half of the patients remained PEG-tube independent, the majority improved their ability to swallow.
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29
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Gómez ÁA, Guerrero D, Hani AC, Cañadas R. [Acute necrotizing esophagitis (black esophagus) with secondary severe stenosis]. Rev Gastroenterol Peru 2015; 35:349-354. [PMID: 26802889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report the case of a 67 years old patient with a history of diabetes mellitus, atrial fibrillation and chronic renal failure, who developed diabetic ketoacidosis and severe sepsis, later presenting an acute necrotizing esophagitis, and then a esophageal stenosis requiring treatment with self-expanding esophageal prosthesis with good clinical results.
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Affiliation(s)
| | | | - Albis C Hani
- Hospital Universitario San Ignacio. Bogotá, Colombia
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30
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Karmazanovsky GG, Buryakina SA, Kondratiev EV, Yang Q, Ruchkin DV, Kalinin DV. Value of two-phase dynamic multidetector computed tomography in differential diagnosis of post-inflammatory strictures from esophageal cancer. World J Gastroenterol 2015; 21:8878-8887. [PMID: 26269677 PMCID: PMC4528030 DOI: 10.3748/wjg.v21.i29.8878] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/25/2015] [Accepted: 05/07/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To characterize the computed tomography (CT) findings in patients with post-inflammatory esophageal strictures (corrosive and peptic) and reveal the optimal scanning phase protocols for distinguishing post-inflammatory esophageal stricture and esophageal cancer.
METHODS: Sixty-five patients with esophageal strictures of different etiology were included in this study: 24 patients with 27 histopathologically confirmed corrosive strictures, 10 patients with 12 peptic strictures and 31 patients with esophageal cancer were evaluated with a two-phase dynamic contrast-enhanced MDCT. Arterial and venous phases at 10 and 35 s after the attenuation of 200 HU were obtained at the descending aorta, with a delayed phase at 6-8 min after the start of injection of contrast media. For qualitative analysis, CT scans of benign strictures were reviewed for the presence/absence of the following features: “target sign”, luminal mass, homogeneity of contrast medium uptake, concentric wall thickening, conically shaped suprastenotic dilatation, smooth boundaries of stenosis and smooth mucous membrane at the transition to stenosis, which were compared with a control group of 31 patients who had esophageal cancer. The quantitative analysis included densitometric parameter acquisition using regions-of-interest measurement of the zone of stenosis and normal esophageal wall and the difference between those measurements (ΔCT) at all phases of bolus contrast enhancement. Esophageal wall thickening, length of esophageal wall thickening and size of the regional lymph nodes were also evaluated.
RESULTS: The presence of a concentric esophageal wall, conically shaped suprastenotic dilatation, smooth upper and lower boundaries, “target sign” and smooth mucous membrane at the transition to stenosis were suggestive of a benign cause, with sensitivities of 92.31%, 87.17%, 94.87%, 76.92% and 82.05%, respectively, and specificities of 70.96%, 89.66%, 80.65%, 96.77% and 93.55%, respectively. The features that were most suggestive of a malignant cause were eccentric esophageal wall thickening, tuberous upper and lower boundaries of stenosis, absence of mucous membrane visualization, rupture of the mucous membrane at the upper boundary of stenosis, cup-shaped suprastenotic dilatation, luminal mass and enlarged regional lymph nodes with specificities of 92.31% 94.87%, 67.86%, 100%, 97.44%, 94.87% and 82.86%, respectively and sensitivities of 70.97%, 80.65%, 96.77%, 80.65%, 54.84%, 87.10% and 60%, respectively. The highest tumor attenuation occurred in the arterial phase (mean attenuation 74.13 ± 17.42 HU), and the mean attenuation difference between the tumor and the normal esophageal wall (mean ΔCT) in the arterial phase was 23.86 ± 19.31 HU. Here, 11.5 HU of ΔCT in the arterial phase was the cut-off value used to differentiate esophageal cancer from post-inflammatory stricture (P = 0.000). The highest attenuation of post-inflammatory strictures occurred in the delayed phase (mean attenuation 71.66 ± 14.28 HU), and the mean ΔCT in delayed phase was 34.03 ± 15.94 HU. Here, 18.5 HU of ΔCT in delayed phase was the cut-off value used to differentiate post-inflammatory stricture from esophageal cancer (P < 0.0001).
CONCLUSION: The described imaging findings reveal high diagnostic significance in the differentiation of benign strictures from esophageal cancer.
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Cao J, He Y, Liu HQ, Wang SB, Zhao BC, Cheng YS. Percutaneous radiologic gastrostomy via nasopharyngeal intubation for the treatment of patients with complete malignant pharyngoesophageal obstruction. Hepatogastroenterology 2015; 62:319-322. [PMID: 25916056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIMS For patients with complete malignant pharyngoesophageal obstruction (CMPO), percutaneous radiologic gastrostomy (PRG) under ultrasound/CT guidance can complicate it to cause failure due to unsatisfied stomach filling. In this study, we retrospectively investigated whether PRG via nasopharyngeal intubation is feasible and effective for these patients. METHODOLOGY PRG via nasopharyngeal intubation was attempted in 21 patients with CMPO (mean 70.8 ± 8.23 years). The technique comprised a dilation of the stomach via nasopharyngeal intubation using a catheter, followed by fluoroscopically guided puncture and gastrostomy tube placement. Complications including hemorrhage, peritonitis, gastrojejunocolic fistula, infection of puncture site, tube blocking and outleakage was observed during and after the procedure. RESULTS A 5F catheter was successfully inserted to the stomach under fluoroscopical guidance and subsequent PRG was performed in all 21 patients. Minor complications occurred in 14.3% patients including mild infection of the fistula in 1, tube blocking in 1 and unexpected tube drawing out in 1. Follow-up nutrition indexes revealed obvious improved nutrition compared to before PRG (P < 0.05). CONCLUSION PRG via nasopharyngeal intubation was simple, feasible and effective for patients with CMPO.
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32
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Kehar M, Sharma M. Esophageal stricture following retained foreign body in a child. Indian Pediatr 2015; 52:162-163. [PMID: 25691195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Mohit Kehar
- Division of Pediatric Gastroenterology and Hepatology, Institute of Child Health, Sir Ganga Ram Hospital, Delhi; and #Jaswant Rai hospital, Meerut, UP.
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33
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Hofmeyr R, Myburgh A. Use of transabdominal ultrasound to enhance safety during oesophageal dilatation. Br J Anaesth 2013; 111:125-6. [PMID: 23794661 DOI: 10.1093/bja/aet185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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34
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Ivanov AP, Miroshnikov BI, Iakunin SI, Pavlov PV, Kopiakov AL, Galkina NV. [Esophagoplasty in combined scarry lesions of the esophagus, laryngopharynx and the trachea in children]. Vestn Khir Im I I Grek 2013; 172:59-65. [PMID: 24640751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The experience of plasty of the pharynx and esophagus with graft of the free small intestine segment was presented in 12 children after burn stricture by the potassium permanganate. The technical aspects of operation using methods of the reconstructive vascular surgery were described. Good short-term result was obtained in all the patients. The long-term results were investigated during 15 years. It was observed, that the graft diverticulum developed by 4-7 years in 3 patients, whom repeated operation should be performed. According to the authors, the regional plasty of the esophagus by free revasculizated small intestine graft was really effective surgical supply and could be considered as the method of choice in limited scarry lesions of the pharynx and cervical esophagus, but the method should be improved.
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35
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Spiliopoulos S, Sabharwal T, Krokidis M, Gkoutzios P, Mellerio J, Dourado R, Adam A. Fluoroscopically guided dilation of esophageal strictures in patients with dystrophic epidermolysis bullosa: long-term results. AJR Am J Roentgenol 2012; 199:208-12. [PMID: 22733914 DOI: 10.2214/ajr.11.8159] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the immediate and long-term outcomes after fluoroscopically guided balloon dilation of esophageal strictures in a series of patients with dystrophic epidermolysis bullosa (DEB). MATERIALS AND METHODS Between 2005 and 2011, the medical records of all patients with DEB treated with fluoroscopically guided balloon dilation of esophageal strictures were included in the study and retrospectively analyzed. The indication for treatment was dysphagia attributed to at least one radiologically verified esophageal stricture. The primary endpoints of the study included procedural technical success, clinical improvement assessed with a 0-4 dysphagia score, and major complication rate. Secondary endpoints were patient survival and reintervention rates. RESULTS Nineteen consecutively registered patients with DEB (age range, 10-51 years; mean, 30 ± 12.2 years) and dysphagia due to esophageal strictures were treated with fluoroscopically guided balloon dilation. In total, 90 procedures and 121 dilations were performed to manage 28 lesions. Balloon diameter ranged from 8 to 18 mm. The mean follow-up time was 47.51 ± 16.64 months (range, 17-73 months). The technical success rate was 96.7% (87/90). There were no major complications. The mean reintervention rate was 1.19 dilations per patient per year, and the postprocedural dysphagia score (0.72 [95% CI, 0.56-0.87]) was significantly lower than baseline (2.50 [95% CI 2.35-2.65]) (p < 0.001). CONCLUSION Repeated fluoroscopically guided balloon dilation is safe and effective for the management of dysphagia caused by esophageal strictures in DEB. Use of this technique was associated with marked clinical improvement in dysphagia and satisfactory long-term reintervention rates with no major complications.
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Affiliation(s)
- Stavros Spiliopoulos
- Department of Interventional Radiology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Lambeth Wing, 1st fl, Westminster Bridge Rd, London SE1 7EH, UK.
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36
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Gibadulin NV, Gibadulina IO. [The regurgitation prophylaxis after the distal esophagus resection]. Khirurgiia (Mosk) 2012:59-64. [PMID: 22678539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The clinical use of esophagogastroplasty with antireflux gastroesophageal anastomosis was analyzed basing on the data of 11 operated patients. All patients had benign strictures of the esophagus were operated on transhiatally. The long-term and early results demonstrated the efficacy of the sphincter-valve gastroesophageal anastomosis in prevention of reflux after distal esophagus resection and primary esophagogastroplasty.
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37
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Isohata N, Naritaka Y, Asaka S, Shimakawa T, Miyaki A, Yamaguchi K, Murayama M, Katsube T, Ogawa K. [Three cases of the malignant esophageal stenosis successfully treated with the Niti-S™ esophageal stent]. Gan To Kagaku Ryoho 2011; 38:2417-2419. [PMID: 22202399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We herein report three cases of the malignant esophageal stenosis successfully treated with the Niti-S™ esophageal stent. CASE 1: The hilar lung cancer and its mediastinal lymph node metastasis pressed the esophagus extramurally and caused the marked stenosis. CASE 2: A metastatic lymph node along the left laryngeal nerve caused the stenosis of the trachea. A primary esophageal lesion located at the middle thoracic esophagus also caused the marked stenosis. At first, tracheal stent was placed because of dyspnea, and two weeks later, we placed an esophageal stent. Case 3: Esophageal cancer at lower thoracic esophagus after definitive radiation therapy caused the marked stenosis. Because of the stenosis of esophago-gastric junction( EGJ), we used an esophageal stent with a long cover in order to prevent a reflux into the esophagus. This new Niti-STM esophageal stent was easy to place at the stenosis without difficulty using a conventional device. The symptom was improved immediately for each case. We hope this new device will be used widely.
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Affiliation(s)
- Noriyuki Isohata
- Dept. of Surgery, Tokyo Women's Medical University Medical Center East
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38
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Arora A, Puri SK, Kapoor A, Upreti L, Aggarwal A. Gastrocoele due to concomitant distal esophageal and antral stricture following corrosive ingestion. Trop Gastroenterol 2011; 32:244-246. [PMID: 22332350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Ankur Arora
- Department of Radiology, G.B. Pant Hospital, New Delhi, India.
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39
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Romeo E, Foschia F, de Angelis P, Caldaro T, Federici di Abriola G, Gambitta R, Buoni S, Torroni F, Pardi V, Dall'oglio L. Endoscopic management of congenital esophageal stenosis. J Pediatr Surg 2011; 46:838-41. [PMID: 21616237 DOI: 10.1016/j.jpedsurg.2011.02.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 02/11/2011] [Indexed: 12/30/2022]
Abstract
BACKGROUND/PURPOSE Congenital esophageal stenosis (CES) is a rare malformation. Endoscopic dilations represent a therapeutic option. This study retrospectively evaluated the efficacy and safety of a conservative treatment of CES. PATIENTS AND METHODS Patients diagnosed with CES since 1980 by a barium study or endoscopy were reviewed. Endoscopic ultrasonography (Olympus UM-3R-20-MHz radial miniprobe, Olympus Corporation, Tokyo, Japan), available from 2001, allowed for the differential diagnosis of tracheobronchial remnants (TBR) and fibromuscular hypertrophy (FMH) CES. All children underwent conservative treatment by endoscopic dilations (hydrostatic and Savary). RESULTS Forty-seven patients (20 men) had CES. Fifteen were associated with esophageal atresia; and 8, with Down syndrome. Mean age at the diagnosis was 28.3 months (range, 1 day to 146 months). Symptoms were solid food refusal, regurgitation, vomiting, and dysphagia. Congenital esophageal stenosis was located in the distal esophagus. Endoscopic ultrasonography demonstrated TBR and FMH in 6 patients. One hundred forty-eight dilations in 47 patients were performed. The stenosis healed in 45 (95.7%). Complications were 5 (10.6%) esophageal perforations, hydrostatic (3/32, or 9.3%), and Savary (2/116, or 1.7%). At follow-up, 1 patient with FMH CES and 1 patient with TBR CES required operation for persistent dysphagia. CONCLUSIONS The conservative treatment yielded positive outcomes in CES. Endoscopic ultrasonography allows for a correct diagnosis of TBR/FMH CES. A surgical approach should be reserved for CES not responsive to dilations.
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Affiliation(s)
- Erminia Romeo
- Digestive Surgery and Endoscopy Unit, 00165 Rome, Italy.
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40
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Al-Tokhais TI, Ahmed AM, Aljubab AS. Congenital esophageal stenosis and antral web. A new association and management challenge. Saudi Med J 2010; 31:1166-1168. [PMID: 20953536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Congenital esophageal stenosis is a rare condition that may be associated with other anomalies. Antral web is also a rare congenital condition. Association of both conditions is extremely rare. We present this rare association in preterm baby in whom initially misdiagnosis of esophageal atresia and trachea-esophageal fistula then followed by a dilemma in differentials diagnosis to explain the uneventful postoperative recovery. The aim of this report is to highlight the diagnostic and therapeutic difficulty of this rare condition.
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Affiliation(s)
- Tariq I Al-Tokhais
- Department of Pediatric, Surgery, King Fahd Medical City, Riyadh, Kingdom of Saudi Arabia
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41
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Dimofte G, Moldovanu R, Crumpei F, Grigoras O, Tarcoveanu E. Incomplete deployment of an expandable metallic stent in a patient with esophageal malignant stenosis. J Gastrointestin Liver Dis 2010; 19:325-328. [PMID: 20922200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The use of self expandable metallic stents (SEMS) in the palliation of dysphagia due to malignant esophageal stenosis is a gold standard. Covered stents are used in all cases with overt air-digestive fistula or high potential for fistula development. The procedure is associated with a low incidence of procedure-related complications. We present a case with a major accident which developed during stent deployment. The delivery system became blocked and we found it impossible to fully deploy the stent, which remained attached to the introductory system. The stent was forcefully removed and replaced later on with a new stent. This is the first report of a SEMS related accident due to malfunction of the stent deployment system. Stent malfunction is unusual and unlikely to happen, but one should be aware and prepared for such unusual situations.
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Affiliation(s)
- Gabriel Dimofte
- Department of Surgery, Gr. T. Popa University of Medicine and Pharmacy, St. Spiridon University Hospital, Iasi, Romania.
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42
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Tomlow B, Schweizer JJ. [A progressive vomiting pre-schooler]. Ned Tijdschr Geneeskd 2010; 154:A418. [PMID: 20298632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A 4-year-old boy with persistent vomiting had a peptic stenosis of the oesophagus.
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Affiliation(s)
- Ben Tomlow
- Maasstad Ziekenhuis, afd. Kindergeneeskunde, Rotterdam, The Netherlands.
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43
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Voermans M, Skidell J, Winberg F. Surgical repair of an oesophageal stricture and prestenotic dilatation in a horse. Tijdschr Diergeneeskd 2009; 134:740-743. [PMID: 19911736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Prestenotic oesophageal dilatation and stricture were diagnosed in a horse with a history of trauma in the cervical area and recurrent oesophageal obstruction. The diagnosis was established on the basis of the clinical examination, endoscopy, and positive contrast oesophagography. Conservative treatment was unsuccessful and surgical intervention was necessary. Oesophageal myectomy combined with myoplasty was performed, simultaneously relieving the dilatation and the stricture. No abnormalities were detected 8 weeks after surgery. The horse was on a normal diet and oesophageal obstruction did recur in the subsequent 14 months.
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Affiliation(s)
- M Voermans
- DAP Bodegraven sv, Zuidzijde 63, 241I RT Bodegraven, Nederland.
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44
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Füessl HS. ["Food remains stuck behind the sternum"]. MMW Fortschr Med 2009; 151:26. [PMID: 20070066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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45
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Santra G. Scleroderma esophagus. J Assoc Physicians India 2009; 57:37. [PMID: 19753757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- G Santra
- Dept. of Medicine, North Bengal Medical College, Sushrutanagar, Darjeeling, PIN-734012
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46
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Fleischer-Orlova N, Mansour M, Haage P. [Esophageal intramural pseudodiverticulosis in a patient with Crohn' disease]. Med Klin (Munich) 2008; 103:526-527. [PMID: 18604489 DOI: 10.1007/s00063-008-1080-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Natalia Fleischer-Orlova
- Klinik für diagnostische und interventionelle Radiologie, HELIOS Klinikum Wuppertal, Universitätsklinik Witten/Herdecke, Heusnerstrasse 40, 42283 Wuppertal.
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Nguyen NP, Smith HJ, Moltz CC, Frank C, Millar C, Dutta S, Lee H, North D, Karlsson U, Vos P, Nguyen LM, Sallah S. Prevalence of pharyngeal and esophageal stenosis following radiation for head and neck cancer. J Otolaryngol Head Neck Surg 2008; 37:219-224. [PMID: 19128616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To evaluate the risk and outcome of pharyngoesophageal stenosis in patients who complained of dysphagia following radiation for head and neck cancer. DESIGN Retrospective study. SETTING Veterans Administration hospital. PATIENTS Patients who complained of persistent dysphagia following radiation alone or combined with surgery or chemotherapy for head and neck cancer. Patients were selected if they were cancer free at the time of the swallowing study. All patients had modified barium swallow (MBS) and an endoscopic examination for initial evaluation of their dysphagia. Traditional barium swallow was requested when there was a suspicion of pharyngoesophageal stenosis on MBS. RESULTS Two hundred twenty-two patients underwent MBS for evaluation of dysphagia posttreatment. Traditional barium swallow confirmed the diagnosis of pharyngeal (n = 2) or esophageal (n = 14) stenosis in 16 patients. Eight patients had esophageal stenosis on endoscopic examination. All patients underwent dilatation for relief of their dysphagia. The number of dilatations performed was, respectively, one in 12 patients, two in 4 patients, three in 3 patients, four in 3 patients, five in one patient, and six in one patient. CONCLUSION Pharyngeal and/or cervical esophageal stenosis may be the cause of dysphagia following radiation for head and neck cancer. Esophageal dilatations often offer temporary relief of the dysphagia.
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Affiliation(s)
- Nam P Nguyen
- Department of Radiation Oncology, University of Arizona, Tucson, AZ 85724-5081, USA.
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Saito T, Ise K, Kawahara Y, Yamashita M, Shimizu H, Suzuki H, Gotoh M. Congenital esophageal stenosis because of tracheobronchial remnant and treated by circular myectomy: a case report. J Pediatr Surg 2008; 43:583-5. [PMID: 18358309 DOI: 10.1016/j.jpedsurg.2007.11.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2007] [Revised: 11/10/2007] [Accepted: 11/12/2007] [Indexed: 01/25/2023]
Abstract
Congenital esophageal stenosis (CES) is a rare anomaly, and appropriate management is not well established. We performed myectomy of the esophageal wall in a child with critical esophageal stenosis caused by tracheobronchial remnant (TBR). An 18-month-old boy was admitted to our hospital having frequent vomiting and failure to thrive. Esophagography and esophagoscopy showed abrupt stenosis at the lower esophageal wall. Balloon dilatation was performed but was ineffective. Surgery was performed under a diagnosis of CES because of TBR. Cartilage was palpable in the stenotic esophageal wall, and extirpation of the muscular layer of the stenotic portion was performed, leaving the mucosal layer intact. The muscular layer was closed loosely using interrupted 5-0 absorbable sutures to match the oral and anal sides together. Postoperatively, the esophageal passage was improved to the point that the patient was able to take solid foods without vomiting. This successful outcome suggests that circular myectomy of the TBR is worth recommending as a surgical procedure for short segment and stenosis of patients with CES because of TBR.
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Affiliation(s)
- Takahiro Saito
- First Department of Surgery, Fukushima Medical University, Fukushima-Shi, Fukushima 960-1295, Japan
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Abstract
BACKGROUND Strictures at the pharyngoesophageal junction represent a subgroup of corrosive esophageal strictures requiring a specialized management approach. Non-dilatable cricopharyngeal strictures need surgical intervention. We report the use of the sternocleidomastoid muscle myocutaneous inlay flap (SCMMIF) for reconstruction of the cervical esophagus in patients with corrosive strictures. METHODS A SCMMIF was used in four patients with cricopharyngeal strictures. The surgical technique is described. All patients had complete dilatation of the stenosed cricopharyngeal segment as seen on postoperative endoscopy and contrast studies. One patient was managed successfully for a short midesophageal stricture by serial endoscopic dilatations. Another patient underwent an esophagocoloplasty subsequently for bypass of the long distal esophageal stricture The last two patients await esophagocoloplasty. CONCLUSIONS This is the first report on the use of sternocleidomastoid muscle myocutaneous inlay flap for corrosive cricopharyngeal strictures. The flap is simple to construct, is effective and can be performed in a short time, and yields good cosmetic results.
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Affiliation(s)
- N Ananthakrishnan
- Department of Surgery, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India.
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