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esophagus trauma

Benjamin Nicholson, Harinder Dhindsa, Louis Seay
BACKGROUND: Blunt injuries to the cervical trachea remain rare but present unique and challenging clinical scenarios for prehospital providers. These injuries depend on prehospital providers either definitively securing the injured airway or bridging the patient to a treatment facility that can mobilize the necessary resources. CASE SUMMARY: The case presented here involves a clothesline injury to a pediatric patient that resulted in complete tracheal transection and partial esophageal transection...
October 4, 2016: Prehospital Emergency Care
Adi Osman, Kok Meng Sum
Upper airway ultrasound is a valuable, non-invasive, simple, and portable point of care ultrasound (POCUS) for evaluation of airway management even in anatomy distorted by pathology or trauma. Ultrasound enables us to identify important sonoanatomy of the upper airway such as thyroid cartilage, epiglottis, cricoid cartilage, cricothyroid membrane, tracheal cartilages, and esophagus. Understanding this applied sonoanatomy facilitates clinician to use ultrasound in assessment of airway anatomy for difficult intubation, ETT and LMA placement and depth, assessment of airway size, ultrasound-guided invasive procedures such as percutaneous needle cricothyroidotomy and tracheostomy, prediction of postextubation stridor and left double-lumen bronchial tube size, and detecting upper airway pathologies...
2016: Journal of Intensive Care
Seyed Sajjad Hasheminasab, Ali Mahmoodi, Parvin Mahmoodi, Hossein Maghsood
Ecthyma contagiosum is caused by the orf virus, a member of the genus Parapoxvirus in the family Poxviridae. Humans acquire the infection from contact with infected or recently vaccinated animals in conjunction with skin trauma. In this study, we report two cases of orf infection in two women who had contact with animals. Diagnosis was based, apart from the clinical signs, on histological examination, virus isolation using fetal bovine esophagus cells, electron microscopy and PCR.
June 2016: Virusdisease
Kenneth N Hiller, Carin A Hagberg
Initial management of ingested esophageal foreign bodies involves airway assessment, determination of the requirement for and timing of therapeutic intervention, risk mitigation during removal, and identification of all indicated equipment for retrieval. Long, sharp-pointed objects lodged in the esophagus require emergent attention and should be retrieved endoscopically, if perforation has not occurred. Inducing general anesthesia and rapidly securing the airway can minimize the risk of aspiration, mitigate any effects of tracheal compression, avoid the potential of exacerbating existing trauma, and provide optimal conditions for removal of long, sharp-pointed esophageal foreign bodies...
August 2016: Journal of Clinical Anesthesia
Gesa Wiegand, Christian Schlensak, Michael Hofbeck
The AMPLATZER(TM) Vascular Plug 4 (AVP4) is a self-expandable, replaceable occluder made of Nitinol wire mesh, which allows the safe and effective interventional occlusion of medium size vessels. This report describes an infant diagnosed with pulmonary atresia, ventricular septal defect, and multifocal collateral lung perfusion through four major aortopulmonary collateral arteries (MAPCAs). A central aorto-pulmonary shunt was performed at 4 months of age. Because of postoperative pulmonary hyperperfusion, one of the MAPCAs was closed interventionally using a 5 mm AVP4...
June 3, 2016: Catheterization and Cardiovascular Interventions
Kyle R Taylor, Nicholas A Milone, Carlos E Rodriguez
The naked mole-rat (Heterocephalus glaber) is widely acclaimed to be cancer-resistant and of considerable research interest based on a paucity of reports of neoplasia in this species. We have, however, encountered four spontaneous cases of neoplasia and one presumptive case of neoplasia through routine necropsy and biopsy of individuals in a zoo collection of nonhybrid naked mole-rats bred from a single pair. One case each of metastasizing hepatocellular carcinoma, nephroblastoma (Wilms' tumor), and multicentric lymphosarcoma, as well as presumptive esophageal adenocarcinoma (Barrett's esophagus-like) was identified postmortem among 37 nonautolyzed necropsy submissions of naked mole-rats over 1-year-old that were submitted for necropsy between 1998 and August 2015...
April 29, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Carlo Liguori, Nicola Gagliardi, Pietro Paolo Saturnino, Antonio Pinto, Luigia Romano
Perforation of the esophagus remains a diagnostic and therapeutic challenge. Currently, the most common cause of perforation is instrumentation of the esophagus, but other conditions such as foreign body, trauma, or spontaneous rupture are possible entities in the clinical practice. Multidetector computed tomography has become the imaging technique of choice in the evaluation of this setting of patients because of its capability to depict all the different signs associated with the degrees of wall impairment...
February 2016: Seminars in Ultrasound, CT, and MR
You-Cheng Lin, Jenn-Ren Hsiao, Yao-Chou Lee
Esophageal stricture after surgery or trauma is a major reason for poor oral nutrition, body-weight loss, and general damage to health. Patch esophagoplasty, after repeated failed dilation attempts, is recommended for focal esophageal strictures. In this report, we present a case in which a free proximal lateral leg flap was used for reconstruction of focal stricture of the cervical esophagus. A 62-year-old man developed progressive dysphagia after hypopharyngeal cancer ablation and adjuvant radiotherapy. He was referred for surgical interventions after repeated failed dilation attempts...
January 22, 2016: Microsurgery
C Rory Goodwin, Christine E Boone, James Pendleton, Benjamin D Elder, Zhikui Wei, Wesley Hsu, Daniel M Sciubba, Timothy F Witham
Pneumocephalus is a collection of air within in the intracranial cavity, most commonly seen following traumatic injury or cranial surgeries. Esophageal injury and cerebrospinal fluid (CSF) leak are rare complications that may occur following anterior cervical discectomy and fusion (ACDF). We present a novel case of pneumocephalus arising from unrestricted leakage of CSF via coincident esophageal injury and durotomy in a patient who underwent an ACDF after trauma. A 21-year-old man presented to an outside hospital with C5/C6 subluxation, complete spinal cord injury, and quadriplegia from a motor vehicle accident...
April 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
F R J Groen, D Delawi, M C Kruyt, F C Oner
PURPOSE: This study aimed at discussing the relevance of the type B3 fracture of the new AOSpine classification. METHODS: Hyperextension fractures of the spine are rare in the general population, but common in the ankylotic spine. We present a case of a severe spinal fracture with concomitant esophageal rupture, which was diagnosed early and could be treated during the initial trauma care. RESULTS: The spinal column was stabilized using a percutaneous technique after which the perforated esophagus was sutured through a thoracotomy...
May 2016: European Spine Journal
Ji Hyoung Kim, Jong-Jae Park, Il Woo Jung, Sang Hoon Kim, Hee Dong Kim, Jung Wan Choe, Moon Kyung Joo, Hyun Gu Kim
Esophagopleural fistula (EPF) is a rare condition that is usually accompanied by severe infection and life-threatening morbidity. Here, we report the successful treatment of an EPF by closing an esophageal orifice using the over-the-scope-clip (OTSC) system without postprocedural complications. A 41-year-old man had serious thoracic and abdominal trauma due to a traffic accident. Computed tomography revealed findings suggestive of esophageal rupture due to Boerhaave syndrome. An emergent explorative operation was performed for primary repair with the insertion of a vacuum-assisted closure device...
September 2015: Clinical Endoscopy
Wilhelmus Jacobus Conradie, Fekade Admassu Gebremariam
OBJECTIVE: To determine the sensitivity and specificity of computed tomography (CT) esophagography in diagnosing penetrating esophageal and hypopharyngeal injuries in trauma patients and to see if it can be used as the only imaging method in diagnosing these injuries. The confidence of radiologists using only CT esophagography was also measured. PATIENTS AND METHODS: A prospective cross-sectional analytic study was done on haemodinamically stable patients requiring multidetector CT after external penetrating neck or chest trauma...
November 2015: Clinical Imaging
Thomas R Sanchez, Grant S Holz, Michael T Corwin, Robert J Wood, Sandra L Wootton-Gorges
The purpose of this study was to determine the value of follow-up barium esophogram in diagnosing esophageal injury or leak if the initial water-soluble contrast examination of the esophagus is normal. An institutional review board (IRB)-approved retrospective review of all pediatric patients less than 18 years old referred to the radiology department for evaluation of esophageal injury or leak was performed for a 9-year period from 2005 to 2014. The majority of patients had unexplained pneumomediastinum, chest trauma (gunshot or puncture wound), or foreign body ingestion as the reason for the referral...
October 2015: Emergency Radiology
Todd Jensen, Alex Blanchette, Stephanie Vadasz, Apeksha Dave, Michael Canfarotta, Wael N Sayej, Christine Finck
BACKGROUND/PURPOSE: A tissue-engineered esophagus offers an alternative for the treatment of pediatric patients suffering from severe esophageal malformations, caustic injury, and cancer. Additionally, adult patients suffering from carcinoma or trauma would benefit. METHODS: Donor rat esophageal tissue was physically and enzymatically digested to isolate epithelial and smooth muscle cells, which were cultured in epithelial cell medium or smooth muscle cell medium and characterized by immunofluorescence...
July 2015: Biomaterials
Shixia He, Xiaorui Chen, Xiaowei Zhou, Qingqing Hu, Sunnassee Ananda, Shaohua Zhu
We present 2 rare cases of patients with uncontrolled hemorrhagic shock induced by traumatic ascending aortic pseudoaneurysm rupture into the esophagus. Two men were presented to the hospital after traffic accidents. Their chest radiograph showed no obvious signs of aortic damage or aortic pseudoaneurysms but only a small amount of high-density shadow in the mediastinum and no specific clinical signs besides chest tightness or chest tenderness. The first case was misdiagnosed as pulmonary contusion and pleural effusion, and the second case was misdiagnosed as mediastinal lesions in the mediastina...
April 2015: Medicine (Baltimore)
José Luis Braga de Aquino, José Gonzaga Teixeira de Camargo, Gustavo Nardini Cecchino, Douglas Alexandre Rizzanti Pereira, Caroline Agnelli Bento, Vânia Aparecida Leandro-Merhi
BACKGROUND: Esophageal trauma is considered one of the most severe lesions of the digestive tract. There is still much controversy in choosing the best treatment for cases of esophageal perforation since that decision involves many variables. The readiness of medical care, the patient's clinical status, the local conditions of the perforated segment, and the severity of the associated injuries must be considered for the most adequate therapeutic choice. AIM: To demonstrate and to analyze the results of urgent esophagectomy in a series of patients with esophageal perforation...
November 2014: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Thomas Manwell, Tomáš Vítek, Tommaso Ranzani, Arianna Menciassi, Kaspar Althoefer, Hongbin Liu
This paper presents a new design of worm robot whose body is constructed using a novel crimped elastic mesh braid inspired by the earthworm. The proposed worm robot is intended for inspection within the human body via natural orifices. The design and fabrication procedure of the worm robot are given in the paper. The imitation of peristalsis, used by natural worms, is used to control the worm robot for the purpose of producing motion while causing minimal trauma to biological tissue. The forward locomotive function of the worm robot has been tested on both a flat surface and in a rubber tube...
2014: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
David V Feliciano
Patients with penetrating wounds to the neck present with overt symptoms and/or signs or are asymptomatic or modestly/moderately symptomatic. With overt symptoms and/or signs, immediate resuscitation and an emergency operation are appropriate. Asymptomatic patients or those with modest or moderate symptoms and/or signs undergo observation or a diagnostic evaluation to avoid the 45% "negative" exploration rate documented in the past (denominator = all patients). Asymptomatic patients with penetration of the platysma muscle, but no signs of a visceral or vascular injury, should undergo serial physical examinations every 6-8 for 24-36 h before discharge...
June 2015: World Journal of Surgery
Dan-Hui Yin, Xin-Ming Yang, Qi Huang, Mi Yang, Qin-Lai Tang, Shu-Hui Wang, Shuang Wang, Jia-Jia Liu, Tao Yang, Shi-Sheng Li
Pharyngoesophageal perforation after anterior cervical spine surgery is rare and the delayed cases were more rarely reported but potentially life-threatening. We report a case of pharyngoesophageal perforation 3 years after anterior cervical spine surgery. The patient presented with dysphagia, fever, left cervical mass and developing dyspnea 3 years after cervical spine surgery for trauma. After careful examinations, he underwent an emergency tracheostomy, neck exploration, hardware removal, abscess drainage and infected tissue debridement...
August 2015: European Archives of Oto-rhino-laryngology
I E Khat'kov, R E Izrailov, S A Domrachev, P V Kononets, O S Vasnev, M A Koshkin
Extirpation or subtotal resection of esophagus was performed in 14 patients by using of thoracolaparoscopic technique in terms from November 2011 to March 2014. The mean patients' age was 56 years old (27-67 years). In 10 patients indications for surgery included benign esophagus diseases such as cardiospasm stage IV (2 cases), peptic stricture (5 cases) and burn stricture (3 cases). 4 patients were operated for esophagus cancer including middle one-third cancer in 1 patient, lower one-third cancer in 3 cases...
2014: Khirurgiia
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