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oesophagus dilation

Sarmed S Sami, Hasan N Haboubi, Yeng Ang, Philip Boger, Pradeep Bhandari, John de Caestecker, Helen Griffiths, Rehan Haidry, Hans-Ulrich Laasch, Praful Patel, Stuart Paterson, Krish Ragunath, Peter Watson, Peter D Siersema, Stephen E Attwood
These are updated guidelines which supersede the original version published in 2004. This work has been endorsed by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG) under the auspices of the oesophageal section of the BSG. The original guidelines have undergone extensive revision by the 16 members of the Guideline Development Group with representation from individuals across all relevant disciplines, including the Heartburn Cancer UK charity, a nursing representative and a patient representative...
February 24, 2018: Gut
Divyesh Reddy Nemakayala, Manoj P Rai, Julie L Yam, Heather Laird-Fick
A Dieulafoy's lesion is defined as a dilated, aberrant, submucosal artery that erodes overlying mucosa in the absence of an underlying ulcer, aneurysm or intrinsic mural abnormality. It is a rare cause of upper gastrointestinal (GI) bleed with a very high mortality rate if it goes unidentified. It is most commonly located in the lesser curvature of the stomach but is extremely rare in the oesophagus. We are reporting a 55-year-old man who had massive haematemesis. Emergent endoscopy showed Dieulafoy's lesion in the distal oesophagus...
February 7, 2018: BMJ Case Reports
Ana Gomez-Larrauri, Simon Galloway, Rob Niven
Achalasia is an uncommon oesophageal motor disorder characterized by failure of relaxation of the lower oesophageal sphincter and muscle hypertrophy, resulting in a loss of peristalsis and a dilated oesophagus. Gastrointestinal symptoms are invariably present in all cases of achalasia observed in adults. We report a case of a 34 year-old female patient with long standing history of asthma-like symptoms, labelled as uncontrolled and steroid resistant asthma with no gastrointestinal manifestations. Thoracic CT scan revealed a massive oesophagus due to achalasia, which caused severe tracheomalacia as a result of tracheal compression...
2018: Respiratory Medicine Case Reports
Vaibhav Kumar Varshney, Subhash Chandra Soni, Manju Kumari, Pawan Kumar Garg, Ashok Puranik
Achalasia cardia is an oesophageal motility disorder characterised by aperistalsis and failure of relaxation of the lower oesophageal sphincter. The management is predominantly palliative with focus on addressing the sphincter that involves either pneumatic dilatation or Heller myotomy which relieves dysphagia in the majority of the cases. End-stage achalasia (ESA) is characterised by failed myotomy, massively dilated and tortuous oesophagus with nutritional deterioration due to progressive dysphagia and vomiting...
January 10, 2018: Journal of Minimal Access Surgery
Aikaterini Leventi, Thomas Frederick James Clifford, Amy Arnold, Charles H Knowles, Joanne E Martin
CLINICAL PRESENTATION: A 53-year-old man was admitted with a 2-week history of bowel obstruction on a background of gradually worsening dyspeptic symptoms associated with vomiting and weight loss. He was under regular gastroenterology review for Barrett's oesophagus and had a recent endoscopic diagnosis of megaduodenum (mainly D1 dilatation) confirmed by barium study (figure 1). He was also known to have bladder emptying problems and an enlarged bladder. His mother died at age 28 due to 'megacolon', and he has a monozygotic twin brother with Barrett's oesophagus...
January 5, 2018: Gut
Georgios P Karamanolis, Konstantinos Denaxas, Stylianos Panopoulos, Kalliopi-Vasiliki Bournia, Alexandra Zorbala, Dimitrios Kamberoglou, Dimitrios Schizas, Spiros D Ladas, Petros P Sfikakis
OBJECTIVES: Severe oesophageal disease in patients with systemic sclerosis (SSc), referred as scleroderma oesophagus, is characterised by ineffective or absent peristalsis along with hypotensive oesophagogastric junction (hEGJ). The associations between scleroderma oesophagus and different clinical and laboratory manifestations of SSc is still controversial. In this study we aimed to assess associations between scleroderma oesophagus, diagnosed by high resolution manometry (HRM), and other manifestations of disease...
September 2017: Clinical and Experimental Rheumatology
Matthew Banks, Rami Sweis
Achalasia is a rare oesophageal motility disorder predominantly causing dysphagia and regurgitation of food and fluids. Diagnosis is made typically after a combination of tests including endoscopy, barium swallow and oesophageal manometry. The advent of high-resolution manometry has led to the Chicago Classification which divided achalasia into three types. This improved the understanding of presentation, prognosis and might also help tailor therapy. Botulinum toxin has been shown to have good, but short-term efficacy...
April 2017: Frontline Gastroenterology
Vaibhav Kumar Varshney, Hirdaya H Nag, B G Vageesh
BACKGROUND: Oesophagectomy for corrosive stricture of the oesophagus (CSE) is rarely performed due to high risk of iatrogenic complications. The aims of this study were to review our experience of transhiatal oesophagectomy (THE) in patients with CSE as well as to compare results of open and laparoscopic methods. MATERIALS AND METHODS: This is a retrospective analysis of prospectively maintained data of patients with CSE who underwent open transhiatal oesophagectomy (OTE) or laparoscopic-assisted transhiatal oesophagectomy (LATE) by a single surgical team from 2012 to 2016...
August 1, 2017: Journal of Minimal Access Surgery
Gautier Chene, Lauriane Chauvy, Annie Buenerd, Stéphanie Moret, Béatrice Nadaud, Philippe Chabert, Gery Lamblin
OBJECTIVES: Recently it has been postulated that most ovarian cancers have a tubal origin. The identification of preinvasive tubal lesions would be of great interest in the early diagnosis of ovarian cancer. Optical biopsy has been developed and validated in the detection of precancerous lesions (such as Barrett's oesophagus). The first objective of this study was to assess the feasibility of optical biopsy in the study of fallopian tubes during laparoscopy. The second objective was to describe the images in benign premalignant and malignant tubes with a histopathological and immunohistochemical (p53 and Ki67 expressions) correlation...
July 5, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
R Ananda Raja, R Sridhar, C Balachandran, A Palanisammi, S Ramesh, K Nagarajan
A pathobiological study was conducted using Vibrio parahaemolyticus (VP) strain isolated from vibriosis affected shrimp (Penaeus vannamei) farms in Kancheepuram and Thiruvallur districts of Tamil Nadu during August 2014 to February 2015. The isolate was identified based on the morphological, physiological, biochemical and molecular characters. LD50 value with intramuscular injection was determined as 2.6 × 10(4) cfu/shrimp and sequential pathology was studied giving 6.1 × 10(3) cfu/shrimp (LD25). Total plate count (TPC) and total Vibrio count (TVC) in water, pond sediment, haemolymph, muscle, HP and gut were found significantly (P < 0...
August 2017: Fish & Shellfish Immunology
Daniele Tassinari, Rossana D Berta, Monica Nannipieri, Patrizia Giusti, Luca Di Paolo, Daniela Guarino, Marco Anselmino
BACKGROUND: Remnant dimension is considered one of the crucial elements determining the success of sleeve gastrectomy (SG), and dilation of the gastric fundus is often believed to be the main cause of failure. OBJECTIVES: The main outcome of this study is to find correlations between remnant morphology in the immediate post-operative stage, its dilation in years, and the long-term results. The second purpose aims to correlate preoperative eating disorders, taste alteration, hunger perception, and early satiety with post-SG results...
November 2017: Obesity Surgery
Eduard Jonas, Sebastian Sjöqvist, Peter Elbe, Nobuo Kanai, Jenny Enger, Stephan L Haas, Ammar Mohkles-Barakat, Teruo Okano, Ryo Takagi, Takeshi Ohki, Masakazu Yamamoto, Makoto Kondo, Katrin Markland, Mei Ling Lim, Masayuki Yamato, Magnus Nilsson, Johan Permert, Pontus Blomberg, J-Matthias Löhr
BACKGROUND AND OBJECTIVE: Endoscopic mucosal dissection (ESD) is a treatment option for oesophagus tumours localized to the mucosa enabling en bloc removal of large lesions. The resulting larger mucosal defects have resulted in an increase in the occurrence of post-treatment strictures. Transplantation of autologous cell sheets, cultured from oral mucosa, has been shown to prevent post-ESD strictures. The aim of the study was to assess the efficacy and safety of cell sheet transplantation after oesophageal ESD in a Western patient population where reflux-associated pre-malignant and malignant conditions predominate...
December 2016: United European Gastroenterology Journal
L Mastracci, R Fiocca, C Engström, S Attwood, C Ell, J P Galmiche, J G Hatlebakk, G Långström, S Eklund, T Lind, L Lundell
BACKGROUND: Proton pump inhibitors and laparoscopic anti-reflux surgery (LARS) offer long-term symptom control to patients with gastro-oesophageal reflux disease (GERD). AIM: To evaluate the process of 'normalisation' of the squamous epithelium morphology of the distal oesophagus on these therapies. METHODS: In the LOTUS trial, 554 patients with chronic GERD were randomised to receive either esomeprazole (20-40 mg daily) or LARS. After 5 years, 372 patients remained in the study (esomeprazole, 192; LARS, 180)...
May 2017: Alimentary Pharmacology & Therapeutics
Thomas Marini, Amit Desai, Katherine Kaproth-Joslin, John Wandtke, Susan K Hobbs
Non-malignant oesophageal diseases are critical to recognize, but can be easily overlooked or misdiagnosed radiologically. In this paper, we cover the salient clinical features and imaging findings of non-malignant pathology of the oesophagus. We organize the many non-malignant diseases of the oesophagus into two major categories: luminal disorders and wall disorders. Luminal disorders include dilatation/narrowing (e.g. achalasia, scleroderma, and stricture) and foreign body impaction. Wall disorders include wall thickening (e...
June 2017: Insights Into Imaging
Inam -Ul- Haq, Amir Ali Shah, S Chandramohan
Varices are abnormal dilated veins which result from increased pressure in the portal circulation. Although the oesophagus and stomach are the most common sites for varices to develop, they may also occur as ectopic varices in the duodenum, rectum, and retroperitoneal areas. Isolated duodenal varices involving distal duodenum, particularly the fourth part of the duodenum, are extremely rare. However, such ectopic varices are associated with an increased risk of bleeding and mortality. Not only are they a diagnostic challenge, particularly if they present as a first manifestation of portal hypertension, they are also very difficult to treat due to their location...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Sundeep Singh Saluja, Vaibhav Kumar Varshney, Pramod Kumar Mishra, Siddharth Srivastava, Ravi Meher, Pritul Saxena
BACKGROUND: Pharyngoesophageal stricture (PES) is an Achilles' heel in the management of corrosive injury. Advances in endoscopic techniques were utilized in its management. We classified the stricture as per its dilatability and then planned their treatment. METHODS: PES was sub-categorized based on endoscopic dilatation and availability of cervical oesophagus: group-1 stricture with available cervical oesophagus; group-2 stricture with some part of upper oesophagus made available after endoscopic dilatation and anastomosis in cervico-pharyngeal area; group-3 stricture not amenable for dilatation, anastomosis done at the pharynx...
August 2017: World Journal of Surgery
Faisal Inayat, Waqas Ullah, Qulsoom Hussain, Abu Hurairah
Dieulafoy's lesion is a vascular abnormality consisting of a tortuous, dilated aberrant submucosal vessel that erodes the overlying mucosal layer without ulceration. The oesophagus is a very rare location for the lesion. Herein, we report a case series of 3 patients who presented with upper gastrointestinal bleeding. Endoscopy was performed, which showed a large calibre-persistent tortuous submucosal artery protruding into the oesophageal lumen. All the patients were successfully managed with endoscopic intervention using epinephrine injection around the lesion followed by hemoclip application...
January 6, 2017: BMJ Case Reports
Paulo Castro Soares, Salim Bouayed, Pavel Dulguerov, Jean-Louis Frossard
Complete pharyngo-oesophageal stricture (PES) after radiotherapy for head and neck cancer is a relatively rare and difficult complication to manage. Historically this condition has been treated surgically, but endoscopic approaches are now available. We present a 61-year-old man with an epidermoid carcinoma of the supraglottic stage and a micro-invasive epidermoid carcinoma of the oropharynx treated surgically and subsequently by adjuvant radiotherapy. Eight months after the end of the radiotherapy, a complete PES was diagnosed and treated with a combined anterograde-retrograde endoscopic dilation (CARD)...
September 2016: Case Reports in Gastroenterology
Neeta Santha, Madhusudan Upadya, Sravanthi Vishwanatham
Achalasia cardia is a disorder of the gastrointestinal tract characterized by dilatation of the oesophagus and collection of food and fluids in the oesophagus leading to massive regurgitation and aspiration of gastric contents. Down's syndrome has multisystem effects which can also present as difficult airway. Here, we present a case of a 14-year-old girl, a case of Down's syndrome with Achalasia cardia and mitral valve prolapse posted for Heller's cardiomyotomy. Anaesthetic concerns were difficult airway due to Downs's syndrome, massive aspiration risks of Achalasia cardia and haemodynamic instability due to mitral regurgitation...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
E V Marietta, D M Geno, T C Smyrk, A Becker, J A Alexander, M Camilleri, J A Murray, D A Katzka
BACKGROUND: Although eosinophilic oesophagitis (EoE) is putatively mediated by an abnormal response to food antigen, the oesophagus is considered relatively impermeable to large molecules. AIM: To assess whether food antigens penetrate the oesophageal mucosa in patients with EoE. METHODS: Anti-gliadin staining was performed in three groups: active EoE, inactive EoE and EoE patients on a low or gluten free diet. To appraise the specificity of our results, we also performed gliadin staining on six patients without oesophageal disease who were consuming gluten...
February 2017: Alimentary Pharmacology & Therapeutics
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