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esophageal stricture retrograde dilation

Suyeon Park, Ji Yong Ahn, Young Eun Ahn, Sang-Beom Jeon, Sang Soo Lee, Hwoon-Yong Jung, Jin-Ho Kim
Cerebral air embolism is an extremely rare complication of endoscopic procedure and often life threatening. We present two cases of cerebral infarction due to air embolization caused by an endoscopic intervention. The first case occurred during esophageal balloon dilatation for the treatment of a stricture of an anastomosis site in a 59-year-old man and the second case occurred during endoscopic papillary balloon dilatation in a 69-year-old man who had distal common bile duct stones. After the procedure, cardiopulmonary instability and altered mental status were observed in both patients, and cerebral air embolism was diagnosed in both cases...
March 2016: Clinical Endoscopy
Yaseen Perbtani, Alejandro L Suarez, Mihir S Wagh
BACKGROUND AND STUDY AIMS: Complete esophageal obstruction (CEO) is a rare occurrence characterized by progressive esophageal stricture, which eventually causes lumen obliteration. With recent advances in flexible endoscopy, various innovative techniques exist for restoring luminal continuity. The primary aim of this study was to assess the efficacy and safety of patients undergoing combined antegrade-retrograde endoscopic dilation for CEO at our institution. The secondary aim was to review and highlight emerging techniques, outcomes, and adverse events after endoscopic treatment of CEO...
February 2016: Endoscopy International Open
A T Eminler, M I Uslan, A Ş Köksal, M Guven, E Parlak
Upper esophageal strictures occur in approximately 3-4% of patients who receive radiotherapy for head and neck cancers. The standart initial treatment is dilation by using bougie or through-the-scope balloon dilators. Endoscopic treatment requires the passage of a guidewire through the stricture which cannot be accomplished in some of the patients with complex strictures. Retrograde dilation of esophageal strictures through a mature percutaneous gastrostomy tract have been reported in a limited number of cases and small case series up to date and can be considered as a rescue treatment before considering surgery in such patients...
June 2015: Acta Gastro-enterologica Belgica
Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Yasuhiro Noma, Shigeru Horiguchi, Hiroyuki Okada, Kazuhide Yamamoto
We report a case of biliary drainage for malignant stricture using a metal stent with an ultrathin endoscope through the gastric stoma. A 78-year-old female was referred to our hospital for jaundice and fever. She had undergone percutaneous endoscopic gastrostomy (PEG) for esophageal obstruction after radiation therapy for cancer of the pharynx. Abdominal contrast-enhanced computed tomography showed a 3-cm enhanced mass in the middle bile duct and dilatation of the intra-hepatic bile duct. We initially performed endoscopic retrograde cholangiopancreatography (ERCP) with a trans-oral approach...
June 28, 2015: World Journal of Gastroenterology: WJG
Thorsten Vowinkel, Mike Laukoetter, Rudolf Mennigen, Klaus Hahnenkamp, Antje Gottschalk, Matthias Boschin, Michael Frosch, Norbert Senninger, Dirk Tübergen
In children with severe generalized recessive dystrophic epidermolysis bullosa (RDEB), esophageal scarring leads to esophageal strictures with dysphagia, followed by malnutrition and delayed development. We describe a two-step multidisciplinary therapeutic approach to overcome malnutrition and growth retardation. In Step 1, under general anesthesia, orthograde balloon dilation of the esophagus is followed by gastrostomy creation using a direct puncture technique. In Step 2, further esophageal strictures are treated by retrograde dilation via the established gastrostomy; this step requires only a short sedation period...
June 2015: Endoscopy
David O Francis, Eric Hall, Jennifer H Dang, Gregory R Vlacich, James L Netterville, Michael F Vaezi
OBJECTIVES/HYPOTHESIS: Dysphagia and esophageal stricture are frequent consequences of treatment for head and neck cancer. This study examines the effectiveness of the anterograde-retrograde rendezvous procedure and serial dilations in reestablishing esophageal patency to allow return to oral diet and gastrostomy tube removal in a cohort of patients with complete or near-complete esophageal stricture following nonsurgical cancer treatment. STUDY DESIGN: Retrospective review of patients treated with radiation therapy with or without concurrent chemotherapy presented with complete or near-complete esophageal stricture...
April 2015: Laryngoscope
Arianna Bertocchini, Giuseppe d'Ambrosio, Chiara Grimaldi, Laura del Prete, Fabrizio di Francesco, Piergiorgio Falappa, Lidia Monti, Jean de Ville de Goyet
INTRODUCTION: Portal vein aneurysms (PVAs) are usually located at the vein trunk or at its bifurcation, rarely intra-hepatic, or at the umbilical portion. Etiology remains unclear. METHODS: Three children with PVA were identified over a 5-year period. PVA anatomy was assessed by Doppler Ultrasound, Angio CT/MRI, and trans-jugular retrograde portography. RESULTS: Three children with intrahepatic PVA (including the umbilical portion) were identified during assessment for pre-hepatic portal hypertension: all had splenomegaly and hypersplenism...
March 2014: Journal of Pediatric Surgery
Shashideep Singhal, Syed S Hasan, Dan C Cohen, Timothy Pfanner, Scott Reznik, Sushil Duddempudi
BACKGROUND: Benign occlusive esophageal strictures create substantial morbidity and have poor surgical outcomes. Various endoscopic techniques have been described to manage these strictures. The challenge remains to maintain adequate long-term esophageal patency and to limit the need for serial endoscopic dilations. Little has been reported regarding the management of these benign occlusive strictures. METHODS: We report a case series describing the management of technically challenging benign occlusive esophageal strictures...
September 2013: Therapeutic Advances in Gastroenterology
Jay P Babich, David L Diehl, Michael H Entrup
Complete esophageal obstruction is a challenging problem that is not amendable to standard dilation techniques. Multiple endoscopic techniques as well as radical surgical procedures have been developed with the goal of restoring a patent esophageal lumen. In patients with complete esophageal obstruction, an antegrade-retrograde technique has been described, but this generally depends on the ability to transilluminate across the stricture. Successful transillumination allows for safe direct puncture across the stricture, followed by dilation...
August 2012: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
H Worth Boyce, David S Estores, Joy Gaziano, Tapan Padhya, Janet Runk
BACKGROUND: After chemoradiation therapy for head/neck cancer, some patients develop strictures that progress to complete pharyngoesophageal occlusion. Total lumen occlusion is less often due to other conditions. Enteral access (enterostomy tube) and good nutritional status tend to minimize the significance of dysphagia and therefore may mask recognition of impending complete lumen occlusion. OBJECTIVE: Review outcomes of a 25-year experience with endoscopic lumen restoration (ELR) in 30 patients...
July 2012: Gastrointestinal Endoscopy
Haim Gavriel, Cuong Duong, John Spillane, Andrew Sizeland
Severely stenosed radiation-induced benign strictures around the level of cricopharyngeus post-radical chemoradiation for head and neck or upper esophageal cancers pose significant management problems. We report our technique of bidirectional assessment and dilatation of pharyngoesophageal strictures in patients with an in situ percutaneous endoscopic gastrostomy (PEG) tube. The upper gastrointestinal surgeon approached the area of stenosis in a retrograde manner through the PEG tube to guide the otolaryngeal surgeon who performed anterograde dilatation via a rigid laryngoscope...
May 2013: Head & Neck
Jonathan Fowlkes, Philip B Zald, Peter Andersen
BACKGROUND: Complete esophageal stricture is a difficult problem to manage. There is limited literature to support clinical decision-making. To evaluate outcomes and efficacy, we performed a retrospective medical chart review of patients who received combined anterograde retrograde esophageal dilation (CARD) between 2002 and 2009 at our institution. METHODS: Fifteen patients were identified who developed a stricture requiring CARD after treatment for head and neck cancers...
June 2012: Head & Neck
M P Kos, E F David, H F Mahieu
BACKGROUND: Strictures of the hypopharynx and oesophagus are frequently observed following (chemo)radiation. Anterograde dilatation of a complete stenosis carries a high risk of perforation. An alternative is described: a combined anterograde-retrograde approach. CASE REPORT: A 75-year-old man developed complete stenosis of the oesophageal inlet after primary radiotherapy for laryngeal carcinoma and full percutaneous endoscopic gastrostomy feeding. To prevent creation of a false route into the mediastinum, a dilatation wire was introduced in a retrograde fashion into the oesophagus, through the gastrostomy opening...
July 2011: Journal of Laryngology and Otology
Alexander Langerman, Kerstin M Stenson, Mark K Ferguson
BACKGROUND: Esophageal stricture is a well-known complication of chemoradiotherapy for head and neck malignancies. These strictures almost exclusively occur in the cervical esophagus within the field of radiation. For some patients, identification of the esophageal lumen for antegrade dilation of these strictures can be a challenge, and creation of a false lumen can occur during attempts at dilation. METHODS: We report a method of identifying the esophageal lumen using retrograde esophagoscopy through an existing gastrostomy, thereby allowing confident dilation of an esophageal stricture...
July 2010: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Evan S Dellon, Nicole R Cullen, Ryan D Madanick, Robert A Buckmire, Ian S Grimm, Mark C Weissler, Marion E Couch, Nicholas J Shaheen
BACKGROUND: Treatment of head, neck, and esophageal cancers with radiation therapy can lead to esophageal strictures. In some cases, these can progress to complete esophageal obstruction, precluding typical antegrade endoscopic dilation. OBJECTIVE: The aim of this study was to review our experience with a combined antegrade/retrograde technique for dilation of complete esophageal strictures. DESIGN: Case series. SETTING: Tertiary-care referral center...
June 2010: Gastrointestinal Endoscopy
S-H Yeh, Y-H Ni, W-M Hsu, H-L Chen, J-F Wu, M-H Chang
INTRODUCTION: Preserving the native esophagus is critical for long-term swallowing function in patients with esophageal atresia (EA). However, long esophageal gaps and hidden distal esophageal pouches are frequently encountered, making primary esophageal anastomosis very difficult in cases with isolated EA. This study evaluates the efficacy of retrograde esophagoscopy for the identification of distal esophageal pouches to aid primary esophageal anastomosis in patients with isolated EA...
January 2010: European Journal of Pediatric Surgery
B Pogorzelski, R Kiesslich, W Mann
BACKGROUND: Hypopharyngeal stricture can result from a number of causes including chemoradiotherapy and esophagectomy and leads to inability to swallow with aspiration as well as permanent dependence on a gastrostomy tube. Antegrade dilatation or puncture and local mitomycin C application are often unsuccessful and many patients require extensive surgery. METHODS: We report three cases of total hypopharyngeal stenosis with different clinical histories. We present our experience using three modifications of the combined anterograde-retrograde endoscopic technique with resection of the stenosis by laser technique under diaphanoscopic control...
August 2009: HNO
Shou-jiang Tang, Shailender Singh, John M Truelson
BACKGROUND: Pharyngo-esophageal stenosis (PES) and upper esophageal stricture are common in patients who receive radiation therapy for laryngeal and hypopharyngeal cancers. In severe or complete stenosis, the patients generally have complete dysphagia with inability to swallow their saliva. Diagnostic and therapeutic esophagogastroduodenoscopy (EGD) plays an important role in investigating the dysphagia and in managing the underlying stenosis. METHODS AND RESULTS: We translate endoscopic retrograde cholangiopancreatography (ERCP) techniques and skills in approaching pancreaticobiliary obstruction in the management of severe and complete PES...
January 2010: Surgical Endoscopy
Marcus M Malek, Sohail R Shah, Aviva L Katz, Timothy D Kane
PURPOSE: Caustic ingestion is a common cause for acquired esophageal strictures in children. Thoracoscopic esophagectomy can be very useful in this setting, particularly for short segments of disease [1-4]. Thus far, the use of endoscopy to guide resection margins has not been described. METHODS: A 6-year-old boy developed a tight, short esophageal stricture from a lye ingestion injury at the age of 4 years. He had a gastrostomy tube placed at the time for supplemental feedings and subsequently failed attempts at antegrade and retrograde esophageal dilatation...
January 2010: Surgical Endoscopy
E Macher, L Michaud, D Guimber, M Bonnevalle, D Turck, F Gottrand
No abstract text is available yet for this article.
2009: Endoscopy
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