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https://www.readbyqxmd.com/read/29166132/imaging-of-iatrogenic-esophageal-injuries-using-optimized-ct-esophageal-leak-protocol-pearls-and-pitfalls
#1
Rachna Madan, Olga Laur, Breland Crudup, Latia Peavy, Brett W Carter
Iatrogenic injury to the esophagus is a serious complication which is increasingly seen in clinical practice secondary to expansion and greater acceptability of surgical and endoscopic esophageal procedures. Morbidity and mortality following such injury is high. This is mostly due to an inflammatory response to gastric contents in the mediastinum, and the negative intra-thoracic pressures that may further draw out esophageal contents into the mediastinum leading to mediastinitis. Subsequently, pulmonary complications such as pneumonia or abscess may ensue leading to rapid clinical deterioration...
November 22, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29164672/resection-of-an-intra-esophageal-bronchogenic-cyst-by-endoscopic-submucosal-dissection
#2
Alexandros Raptis, Pierre H Deprez, Anne Jouret-Mourin
Bronchogenic cysts are rare foregut abnormalities that arise from aberrant budding of the tracheobronchial tree early in embryological development. They account for 10% to 15% of all primary masses of the mediastinum (1), where they appear predominantly and may compress nearby structures. Intra-esophageal bronchogenic cysts are rare and have only been reported in 23 adult cases since 1981 (2). We report an intra-esophageal bronchogenic cyst that was removed by endoscopic mucosal dissection (ESD). This article is protected by copyright...
November 22, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29164568/cystic-hygroma-of-the-neck-single-center-experience-and-literature-review
#3
C Damaskos, N Garmpis, M Manousi, A Garmpi, G-A Margonis, E Spartalis, C Doula, C Michail-Strantzia, N Patelis, D Schizas, P-T Arkoumanis, N Andreatos, G Tsourouflis, N Zavras, K Markatos, K Kontzoglou, E A Antoniou
OBJECTIVE: Malformations of the lymphatic system are recognized as benign congenital tumors that affect infant and children in the perinatal era. In children, these abnormalities usually found in the neck and the axillary region, but they can present in other parts of the body such as mediastinum, pelvis, retroperitoneum as well as in solid organs (e.g., adrenal glands, pancreas, stomach). Our aim is to report our experience on cystic hygromas via two cases and review the literature. MATERIALS AND METHODS: Herein we present two cases of cystic hygroma, the first of female children and the second of a female adult patient respectively...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29154422/beta-blocker-dose-and-markers-of-sympathetic-activation-in-heart-failure-patients-interrelationships-and-prognostic-significance
#4
Alain Cohen-Solal, Arnold F Jacobson, Ileana L Piña
AIMS: Extent of cardiac sympathetic activation can be estimated from physiological parameters, blood biomarkers, and imaging findings. This study examined the prognostic value of three markers of sympathetic activity and their relationship to beta blocker dose in heart failure patients. METHODS AND RESULTS: A post hoc analysis of 858 heart failure subjects in the ADMIRE-HF trial was performed. Variables related to sympathetic activity were plasma norepinephrine, baseline heart rate, the heart to mediastinum (H/M) ratio of (123) I-mIBG uptake, and beta blocker dose...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29148641/ganglioneuroma-of-the-neck-a-case-report
#5
Woubedel Kiflu, Tihitena Negussie
Ganglioneuroma (GN) is benign tumor arising from sympathetic ganglion which commonly occurs at posterior mediastinum, retroperitoneum and adrenal gland. Rarely, it may also present in cervical region as slow growing painless neck mass. Here we present a 7 years old female child with 4 years duration of slow growing left lateral neck mass. After proper investigations the patient was prepared & taken to the operation room for complete excision of the mass. Post operation biopsy settled the definitive diagnosis as Ganglioneuroma...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29145993/an-absorbable-hydrogel-spray-reduces-postoperative-mediastinal-adhesions-after-congenital-heart-surgery
#6
Nahidh Hasaniya, Anees Razzouk, Jennifer Newcombe, Dana Hassneiah, Jessica Heimes, Joshua Gysbers, Timothy Martens, Leonard Bailey
BACKGROUND: Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a synthetic bioabsorbable polymer spray after cardiac reoperations in infants. METHODS: A prospective randomized double-blinded study was designed. Forty infants requiring staged cardiac operations were randomly allocated to a study group (n = 20) or a control group (n = 20)...
November 14, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29145264/influences-of-cardiac-motion-on-computed-tomography-guided-biopsy-of-lung-nodules-located-near-the-heart
#7
Li-Sheng Hsu, Chien-Wei Chen, Chia-Hao Chang, Chien-Han Liao, Sheng-Lung Hsu, Wei-Ming Lin
Computed tomography (CT)-guided lung biopsy of nodules located near the heart may be associated with potential complications. To understand the influences of cardiac motion on lung parenchyma during biopsy, we processed the cardiac phase images of coronary CT angiography (CCTA) and noticed shifts in mediastinum lung margin (MLM) at different zones.Thirty eight CCTA (27 men and 11 women) were retrospectively evaluated. Image processing was done with Fiji (an open source Java image processing program by Fiji contributors) using 10% to 90% phase images of CCTA; and tissue displacement (MLM shift) was shown on the resulting images...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144018/navigated-retrograde-endoscopic-myotomy-rem-for-the-treatment-of-therapy-resistant-achalasia
#8
K D Pham, R F Havre, T Langø, E F Hofstad, G A Tangen, R Mårvik, T Pham, O H Gilja, J G Hatlebakk, A Viste
BACKGROUND: In achalasia, muscle spasm may involve the proximal esophagus. When the muscle spasm is located in the proximal esophagus, conventional per oral endoscopic myotomy (POEM) may not be sufficient to relieve symptoms. In this paper, we describe retrograde endoscopic myotomy (REM) as a novel approach to perform myotomy of the proximal esophagus, with the application of a navigation tool for anatomical guidance during REM. We aim to evaluate the feasibility and safety of REM and usefulness of the navigation during REM...
November 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29143913/chylothorax-post-thoracoscopic-surgery-for-an-anterior-mediastinal-tumor
#9
Hironori Ishibashi, Yuya Ishikawa, Ayaka Asakawa, Sachiko Imai, Masashi Kobayashi, Kenichi Okubo
Chylothorax after anterior mediastinal surgery is rare. We treated a 39-year-old woman who presented with progressive dyspnea over 6 months. Chest computed tomography revealed a 12-cm round mass in the right anterior mediastinum. She underwent video-assisted thoracoscopic surgery for successful excision of the tumor; however, the surgery was complicated by the development of chylothorax. It was treated surgically with no recurrence of the tumor and/or chylothorax for 2 years. Chylothorax should be recognized as a postsurgical complication of anterior mediastinal tumors...
November 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29137919/neurenteric-cyst-at-the-dorsal-craniocervical-junction-in-a-child-case-report
#10
Pui Man Rosalind Lai, Mohamed A Zaazoue, Roosevelt Francois, Daniel G Dupervil, Aaron L Berkowitz, Sanda Alexandrescu, Mark R Proctor
Neurenteric cysts, also known as enterogenous cysts, are uncommon, benign, congenital lesions that usually occur in the posterior mediastinum but can be seen at any level of the neuraxis. Here, we report a pediatric patient with a neurenteric cyst in the dorsal craniocervical junction as the only third reported pediatric case in the literature in this rare location, and describe the clinical course and pathologic findings with a review of the literature on this rare entity.
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29130015/jejunal-diverticular-perforation-causing-small-bowel-obstruction-in-a-type-4-hiatal-hernia-a-rare-case-report-of-a-nonagenarian-patient-and-review-of-relevant-literature
#11
Saptarshi Biswas, Shekhar Gogna, Prem Patel
Type IV paraesophageal hernia (PEH) is very rare and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a case of a 90-year-old male patient who presented at our emergency department complaining of epigastric pain that he had experienced over the past few hours and getting progressively worse. On the day after admission, his pain became severe. Chest radiography revealed an intrathoracic intestinal gas bubble; emergency exploratory laparotomy identified a type IV PEH with herniation of only the jejunum with perforated diverticula on mesenteric side through a hiatal defect into mediastinum...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29127917/a-giant-mediastinal-liposarcoma-weighing-3500g-resected-with-clam-shell-approach-a-case-report-with-review-of-literature
#12
Yasoo Sugiura, Toshinori Hashizume, Hiroyuki Fujimoto, Etsuo Nemoto
INTRODUCTION: Liposarcoma is rare in the mediastinum and is less than 1% of all mediastinal tumors. In the present report, we demonstrated our case and summarized the principal treatment of the mediastinal liposarcoma with literature review. PRESENTATION OF CASE: A 50-year-old man presented at our hospital with complain of dyspnea. Chest radiography showed remarkable cardiomegaly. Computed tomography revealed an anterior mediastinal tumor from the level of the cephalic vein to the diaphragm of bilateral thoracic cavity with fat component...
November 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29127751/-the-benefit-of-new-angiogenesis-bevacizumab-and-aflibercept-inhibitors-for-multiple-angiomatosis-therapy-a%C3%A2-case-report
#13
Dagmar Brančíková, Lenka Ostřížková, Zdeněk Adam, Tomáš Nebeský, Luděk Pour, Zdeněk Král, Jiří Mayer
Angiomatosis is a term for multiple, gradually proliferating hemangiomas (angiodysplasia), affecting multiple organs or tissues at the same time. We describe a 12-year course of treatment of a patient with multiple hemangiomas located in the abdomen, retroperitoneum, oesophagus, mediastinum and also in vertebrae. The diagnosis was made in 2005 within probatory laparotomy, at the age of 28 years. The treatment was commenced right after making the diagnosis with interferon α. Due to its adverse effects (fatigue, anorexia), the use of interferon α was limited to the first year, after which the interferon dose was gradually being reduced until it was discontinued completely...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29124034/internal-drainage-of-an-esophageal-perforation-in-a-patient-with-a-high-surgical-risk
#14
Hongsun Kim, Younghwan Kim, Jong Ho Cho, Yang Won Min
A 71-year-old man presented with a productive cough and fever, and he was diagnosed as having an esophageal perforation and a mediastinal abscess. He had a history of traumatic hemothorax and pleural drainage for empyema in the right chest and was considered unable to tolerate thoracic surgery because of sepsis and progressive aspiration pneumonia. In order to aggressively drain the mediastinal contamination, we performed internal drainage by placing a Levin tube into the mediastinum through the perforation site...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29123893/a-case-of-omental-herniation-through-the-esophageal-hiatus-successfully-treated-by-laparoscopic-surgery
#15
Koichiro Sueyoshi, Yoshiaki Inoue, Yuka Sumi, Ken Okamoto, Daisuke Azuma, Seiichiro Yoshikawa, Masaki Fukunaga, Hiroshi Tanaka
Case: We report a rare case of omental herniation through the esophageal hiatus. A 46-year-old man visited our emergency department complaining of epigastralgia. Abdominal examination revealed muscular defense and rebound tenderness in his upper abdomen. A computed tomography scan showed a fat density mass in the posterior mediastinum. A laparoscopic operation was carried out under the diagnosis of omental herniation through the esophageal hiatus. Outcome: Abdominal pain disappeared dramatically after the operation...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123892/a-case-of-panspinal-epidural-abscess-that-presented-with-meningeal-irritation
#16
Naoki Okada, Takashi Nishiyama, Maki Kurihara, Yusuke Nishimura, Yoshiro Nishimura, Yukihiro Ando, Saori Otsubo, Katsumi Yamada, Yuji Maeda
Case: In rare cases, spinal epidural abscess involves the entire spine and can lead to neurological deficits and sepsis if treatment is delayed or suboptimal. A 65-year-old man was admitted with a diagnosis of bacterial meningitis. After admission, magnetic resonance imaging showed a spinal epidural abscess from the cervical to lumbar spine. Blood culture revealed Staphylococcus aureus. The patient was initially treated medically because he had no neurological deficits. Repeat blood culture remained positive and abscesses were found in the mediastinum and bilateral psoas muscles...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29104205/-mediastinal-hemangioma-mimicking-a-mature-cystic-teratoma-report-of-a-case
#17
Jun Nakano, Toshihiro Ikeda
A 16-year old young man was referred to our hospital due to abnormal mass of mediastinum on chest radiography. Chest computed tomography scan revealed 45 mm mass in diameter with low density areas and ring shaped calcification at right upper mediastinum. However, chest magnetic resonance imaging showed no existence of fat nor calcification. Although no typical findings was observed, surgical resection was performed because mature cystic teratoma was undeniable. At complete video-assisted thoracoscopic surgery, tumor was found to be in the upper mediastinum covered with mediastinal pleura and with dense fibrous structures around it, and was resected with surrounding fat tissue...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29103785/are-esophagocrural-sutures-needed-during-laparoscopic-fundoplication-a-prospective-randomized-trial
#18
Shawn D St Peter, Ashwini Poola, Obinna Adibe, David Juang, Jason D Fraser, Pablo Aguayo, G W Holcomb
PURPOSE: Historically, fundoplication has been performed with extensive dissection of the esophageal attachments to the diaphragm. Previously, we conducted a randomized trial demonstrating that minimal esophageal dissection and mobilization reduce the rate of wrap herniation and the need for reoperation. In that study, four esophagocrural (EC) sutures were placed in both groups to help obliterate the space between the esophagus and diaphragmatic crura. In this current study, we evaluate the need for these EC sutures...
October 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29103370/boerhaave-s-syndrome-complicated-by-a-saccharomyces-cerevisiae-pleural-empyema-case-report-and-review-of-the-literature
#19
Arno Teblick, Hilde Jansens, Karolien Dams, Francis J Somville, Philippe G Jorens
Objective and Importance Boerhaave's syndrome is a sudden and rare form of oesophageal rupture and is often complicated by local or systemic infection of the mediastinum or pleural cavity. Several micro-organisms are documented as cause of pleural empyema in patients with Boerhaave's syndrome. Intervention (& Technique) We report on a previously healthy 74-year-old male who was admitted at a regional hospital with severe retrosternal and abdominal pain after an episode of vigorous vomiting the morning after ingestion of large quantity of beer...
November 5, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29100788/deep-inspiration-breath-hold-intensity-modulated-radiation-therapy-to-the-mediastinum-for-lymphoma-patients-setup-uncertainties-and-margins
#20
Michalis Aristophanous, Pai-Chun M Chi, Jeremy Kao, Ryan Williamson, Sam Tung, Therese Andraos, Sarah A Milgrom, Chelsea C Pinnix, Bouthaina S Dabaja
PURPOSE: Patient setup for treating large target volumes can be challenging. In the present study, we measured the local uncertainties in the treatment of mediastinal lymphoma and investigated the need for region-specific planning target volume (PTV) margins. METHODS AND MATERIALS: The data from 30 patients who had undergone radiation therapy for mediastinal lymphoma were retrospectively analyzed. A computed tomography (CT)-on-rails (CTOR) system in the treatment room was used for daily image guidance...
September 25, 2017: International Journal of Radiation Oncology, Biology, Physics
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