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https://www.readbyqxmd.com/read/27891427/anaesthetic-management-of-a-case-of-down-s-syndrome-with-achalasia-cardia
#1
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
https://www.readbyqxmd.com/read/27878833/presence-of-intraepithelial-food-antigen-in-patients-with-active-eosinophilic-oesophagitis
#2
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...
November 22, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27799228/synchronous-perforations-of-the-oesophagus-and-stomach-by-air-insufflation-an-uncommon-complication-of-endoscopic-dilation
#3
Arthur M Fung, Fion S Chan, Ian Y Wong, Simon Law
A 72-year-old woman had a history of carcinoma of the hypopharynx treated by total laryngectomy, circumferential pharyngectomy and free jejunal graft. Endoscopic dilation of the pharyngojejunal anastomotic stricture resulted in synchronous perforations of the oesophagus and stomach. We postulate that the perforations were caused by high intraoesophageal and intragastric pressure resulted from air insufflation during the procedure; in a situation simulating closed-loop obstruction, because of proximal obstruction by the endoscope at the stricture site and distal obstruction by pylorospasm...
October 31, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27758725/-dysphagia-in-children
#4
E Ten Velde, B C Gonera-de Jong
In this case report we discuss two children with dysphagia. Both presented with difficulties in swallowing and oesophageal impaction of solid food. The first case involves a 16-year-old boy who suffered from dysphagia for many years. After a long diagnostic journey, during which a psychogenic cause was suspected, he was diagnosed with oesophageal achalasia. After a balloon dilatation of the lower oesophageal sphincter his complaints persisted and the treatment procedure was repeated. The second case involves a 15-year-old girl, who presented with a food impaction in the distal oesophagus...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27704201/technical-feasibility-and-tissue-reaction-after-silicone-covered-biodegradable-magnesium-stent-insertion-in-the-oesophagus-a-primary-study-in-vitro-and-in-vivo
#5
Yue-Qi Zhu, Laura Edmonds, Li-Ming Wei, Rei-La Zheng, Ruo-Yu Cheng, Wen-Guo Cui, Ying-Sheng Cheng
OBJECTIVES: Determine the feasibility of and tissue response to biodegradable magnesium-silicone stent insertion into the oesophagus of rabbits. METHODS: Mechanical compression-recovery and degradation behaviours of the stents were investigated in vitro. Thirty rabbits were randomly divided into a magnesium-silicone stent group (n = 15) that received stent insertion into the lower 1/3 of the oesophagus under fluoroscopic guidance and a control group (n = 15)...
October 4, 2016: European Radiology
https://www.readbyqxmd.com/read/27379433/double-lumen-poliamid-tube-stent-for-the-treatment-of-recurrent-post-corrosive-oesophageal-stenosis
#6
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Leszek Hurkała, Emil Płowiecki
This paper presents the results of endoscopic treatment for recurrent post-corrosive oesophageal stenosis with a tube-stent developed at our institution.The tube-stent was implanted in five children with corrosive oesophageal injury at the age of 2-8.5 years after 7-64 dilatation sessions over 5-118 months. In total, 13 tube-stent were implanted. One patient had nine procedures over 2.5 years and the tube-stent remained in place for 14-250 days. This patient was tube-stent-dependent due to the lack of any possibility of surgical reconstruction...
July 2, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27349160/achalasia-a-13-year-single-centre-experience-comparing-endoscopic-balloon-dilatation-and-laparoscopic-heller-myotomy
#7
Alexander Huelsen, Ramadan Oumer, Anna Ashcroft, Ross H Roberts, Grant N Coulter, Steven J Kelly, Murray L Barclay
BACKGROUND: Idiopathic achalasia is a non-curable, primary motility disorder of the oesophagus. Most established long-term palliative treatment options are laparoscopic Heller myotomy (LHM) and endoscopic balloon dilatation (BD). AIM: We aimed to compare the outcome of both therapies and the risk of serious complications, defined as perforation or death, in a single-centre series. METHOD: In this retrospective study, patients with BD or LHM were identified from 1997-2010...
2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27212130/clinics-in-diagnostic-imaging-168
#8
Yusheng Keefe Lai, Rameysh Danovani Mahmood
A 16-year-old Chinese male patient presented with constipation lasting five days, colicky abdominal pain, lethargy, weakness and body aches. He was able to pass flatus. Abdominal radiography showed a distended stomach causing inferior displacement of the transverse colon. Computed tomography revealed a dilated oesophagus, stomach and duodenum up to its third portion, with a short aortomesenteric distance and narrow angle. There was also consolidation in the lungs bilaterally. Based on the constellation of clinical and imaging findings, a diagnosis of superior mesenteric artery syndrome complicated by aspiration pneumonia was made...
May 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27147631/unusual-case-of-respiratory-embarrassment-secondary-to-tracheal-compression-by-a-dilated-oesophagus-in-a-patient-with-recurrent-achalasia
#9
Andrew Brodie, Nicola Okeahialam, Eriberto Farinella
We present the case of a 79-year-old woman with recurrent achalasia following a laparoscopic Heller's cardiomyotomy. The patient presented to the emergency department, with epigastric pain, severe dyspnoea and profound respiratory acidosis. She required intubation and ventilation followed by gastric decompression with nasogastric tube and the administration of intravenous antibiotics for a lower respiratory tract infection. Once stable, she underwent a CT scan revealing a massively dilated oesophagus causing marked tracheal compression...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27060999/update-on-therapeutic-interventions-for-the-management-of-achalasia
#10
REVIEW
Nishmi Gunasingam, Adam Perczuk, Michael Talbot, Arthur Kaffes, Payal Saxena
Achalasia is a primary esophageal motility disorder. It is the absence of peristalsis in the esophageal body and inability of the lower esophageal sphincter to relax, which characterizes this rare condition. Its features typically include dysphagia, regurgitation, chest pain, and weight loss. The ultimate goal in treating achalasia is to relieve the patient's symptoms, improve esophageal emptying, and prevent further dilatation of the esophagus. Current treatment modalities targeted at achalasia include pharmacological therapy, endoscopic therapy, and surgery...
August 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/26933281/tracheoesophageal-puncture-site-closure-with-sternocleidomastoid-musculocutaneous-transposition-flap
#11
Dushyant Jaiswal, Prabha Yadav, Vinay Kant Shankhdhar, Rajendra Suresh Gujjalanavar, Prashant Puranik
INTRODUCTION: Tracheoesophageal voice prosthesis is highly effective in providing speech after total laryngectomy. Although it is a safe method, in certain cases dilatation or leakage occurs around the prosthesis that needs closure of tracheoesophageal fistula. Both non-surgical and surgical methods for closure have been described. Surgical methods are used when non-surgical methods fail. We present the use of the sternocleidomastoid musculocutaneous (SCMMC) transposition flap for the closure of tracheoesophageal fistula...
September 2015: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/26831678/two-and-three-dimensional-transoesophageal-echocardiography-in-large-swine-used-as-model-for-transcatheter-heart-valve-therapies-standard-planes-and-values
#12
Simon H Sündermann, Nikola Cesarovic, Volkmar Falk, Dominique Bettex
OBJECTIVES: Swine models are widely used to develop new techniques and materials for the treatment of heart valve disease like aortic valve and mitral valve transcatheter interventions and to train physicians in these techniques. Transoesophageal echocardiography (TOE) is crucial in these models. We defined standard planes of 2D and 3D TOE in healthy pigs undergoing transcatheter heart valve interventions. METHODS: Twenty healthy pigs (weight 56-106 kg) underwent different mitral and aortic valve interventions (transcatheter aortic valve implantations, implantations of a mitral band, bicuspidization of the aortic valve, trans-septal punctures)...
May 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/26823346/left-atrial-impression-by-a-dilated-oesophagus-in-a-patient-with-limited-cutaneous-systemic-sclerosis
#13
Kunal Mahajan, Sanjeev Asotra, Prakash Negi, Gunjan Gupta
No abstract text is available yet for this article.
January 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/26648126/consequences-of-bariatric-surgery-on-oesophageal-function-in-health-and-disease
#14
REVIEW
Rishi D Naik, Yash A Choksi, Michael F Vaezi
Obesity is a continuing epidemic with substantial associated morbidity and mortality. Owing to the limitations of lifestyle modifications and pharmacological options, bariatric surgery has come to the forefront as an efficient method of achieving sustained weight loss and decreasing overall mortality in comparison with nonsurgical interventions. The most frequently performed bariatric operations are either purely restrictive, such as laparoscopic adjustable gastric band (LAGB) and laparoscopic sleeve gastrectomy (LSG), or restrictive-malabsorptive, such as the Roux-en-Y gastric bypass (RYGB)...
February 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/26614104/long-term-results-of-the-european-achalasia-trial-a-multicentre-randomised-controlled-trial-comparing-pneumatic-dilation-versus-laparoscopic-heller-myotomy
#15
RANDOMIZED CONTROLLED TRIAL
An Moonen, Vito Annese, Ann Belmans, Albert J Bredenoord, Stanislas Bruley des Varannes, Mario Costantini, Bertrand Dousset, J I Elizalde, Uberto Fumagalli, Marianne Gaudric, Antonio Merla, Andre J Smout, Jan Tack, Giovanni Zaninotto, Olivier R Busch, Guy E Boeckxstaens
OBJECTIVE: Achalasia is a chronic motility disorder of the oesophagus for which laparoscopic Heller myotomy (LHM) and endoscopic pneumodilation (PD) are the most commonly used treatments. However, prospective data comparing their long-term efficacy is lacking. DESIGN: 201 newly diagnosed patients with achalasia were randomly assigned to PD (n=96) or LHM (n=105). Before randomisation, symptoms were assessed using the Eckardt score, functional test were performed and quality of life was assessed...
May 2016: Gut
https://www.readbyqxmd.com/read/26558158/prevalence-of-eosinophilic-oesophagitis-in-adults-presenting-with-oesophageal-food-bolus-obstruction
#16
Neel Heerasing, Shok Yin Lee, Sina Alexander, Damian Dowling
AIM: To look at the relationship between eosinophilic oesophagitis (EO) and food bolus impaction in adults. METHODS: We retrospectively analysed medical records of 100 consecutive patients who presented to our hospital with oesophageal food bolus obstruction (FBO) between 2012 and 2014. In this cohort, 96 were adults (64% male), and 4 paediatric patients were excluded from the analysis as our centre did not have paediatric gastroenterologists. Eighty-five adult patients underwent emergency gastroscopy...
November 6, 2015: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/26336182/oesophageal-lymphangioma-an-exceedingly-rare-tumour
#17
Mara Barbosa, Pedro Moutinho Ribeiro, José Cotter
An asymptomatic 57-year-old man was referred for evaluation of a 10 mm pale pink subepithelial polypoid lesion of the distal oesophagus; the lesion was found incidentally during an upper gastrointestinal endoscopy. The endoscopic ultrasound (EUS) revealed a heterogeneous, although primarily hypoechogenic, well-circumscribed lesion, located in the submucosa. Owing to the absence of endosonographic features, which would have allowed for a precise diagnosis, EUS-guided fine-needle aspiration was performed; however, the cytology was inconclusive because of the lack of cellular representation...
2015: BMJ Case Reports
https://www.readbyqxmd.com/read/26225208/blue-green-endoscopy-in-a-dog-presenting-chronic-vomiting-regurgitation
#18
Matteo Cerquetella, Andrea Spaterna, Beniamino Tesei, Gabrio Bassotti, Giacomo Rossi
A 2-year-old male Maremma sheepdog presenting with chronic vomiting-regurgitation was examined at the University Veterinary Teaching Hospital, Camerino University. An oesophagogastroscopy with a single blue + green (BG) filter restricting wavelengths from 400 to 550 nm was carried out. A conventional white light endoscopy showed a dilated oesophagus with mildly diffuse erythematous mucosa (more accentuated proximal to the cardia); some portions of the gastric mucosa were covered with fluids and appeared only slightly erythematous...
2015: Irish Veterinary Journal
https://www.readbyqxmd.com/read/26117675/efficacy-of-intralesional-triamcinolone-injections-for-benign-refractory-oesophageal-strictures-at-counties-manukau-health-new-zealand
#19
Yeri Ahn, Christin Coomarasamy, Ravinder Ogra
BACKGROUND AND AIMS: Refractory benign strictures of the oesophagus can present a significant clinical challenge and may require repeated attempts at dilatation. Intralesional triamcinolone injections have been used in a limited number of studies to aid in the dilatation of benign, refractory oesophageal strictures. It is hypothesised that intralesional steroid injection inhibits the scar formation, thereby reducing the need for dilatations. The purpose of this study was to assess if steroid injection reduces the need for serial endoscopic dilatations and aids in maintaining oesophageal patency...
June 12, 2015: New Zealand Medical Journal
https://www.readbyqxmd.com/read/26084336/some-nematodes-of-the-genus-rhabdias-stiles-et-hassall-1905-nematoda-rhabdiasidae-parasitising-amphibians-in-french-guiana
#20
Yuriy Kuzmin, Louis H du Preez, Kerstin Junker
Based on material collected from Rhinella cf. margaritifera (Laurenti) and Rhi. marina (Linnaeus) (Anura: Bufonidae) during a parasite survey of the herpetofauna of French Guiana, updated descriptions of Rhabdias androgyna Kloss, 1971 and R. fuelleborni Travassos, 1926 are presented. In addition to metrical data, which may overlap in closely related species, emphasis is placed on qualitative characters. Rhabdias androgyna is distinguished by the unique presence of an outer and inner cephalic cuticular inflation, a shoulder-like broadening of the body at the anterior end, a wide and shallow buccal capsule (average buccal ratio 0...
2015: Folia Parasitologica
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