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trauma esophagus

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
Refık Ülkü, Serdar Onat, Gülşen Yilmaz, Hatice Akay
Esophageal foreign bodies are frequently encountered in the pediatric population and specific high-risk groups of adults. Foreign bodies in the esophagus can result in serious complications, depending on the size and the shape of the ingested object. We report the case of a four-year-old boy with an esophageal injury after the accidental ingestion of an umbrella wire.
December 2009: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
I Jovanovic, K Vormbrock, C M Wilcox, K Mönkemüller
INTRODUCTION: Gastrointestinal (GI) bleeding remains a common clinical problem encountered by every emergency room and trauma physician. Endoscopy remains the main approach to the diagnosis and therapy of GI bleeding. OBJECTIVES: To present the modern endoscopic approach for GI bleeding. METHODS: Narrative review based on our expertise and inclusion of classic articles dealing with interventional and therapeutic GI endoscopy. RESULTS: GI hemorrhage is now classified as upper, middle, and lower GI bleeding...
August 2011: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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
Xiao-Ping Li, Liang Zhang, Lei Li, Bo Yang, Wei-Dong Zhang
Mediastinal emphysema is a status of gas retention in mediastinum, usually caused by airway system injury or esophagus rupture. Healthy people without trauma and basic disease emerging unexplained mediastinal emphysema are called idiopathic mediastinal emphysema. While tension pneumomediastinum is an exceptional and potentially lethal condition, the increased intramediastinal pressure with a severe oppression of heart, vena cava and pulmonary vein leads to impaired central venous return through the cavae system, restricted right heart diastolic filling, and collapse of the cardiac chambers, resulting in reduced stroke volume, cardiac output and dysaemia...
2015: International Journal of Clinical and Experimental Medicine
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
Adonis Nasr, Jéssica Tamara de Oliveira, Melissa Mello Mazepa, Christine Lima Cavalcanti de Albuquerque, Gabriela Soraya Martini, Mariana Nazario, Fábio Henrique de Carvalho
OBJECTIVE: the study has the intention of evaluate the accuracy of computed tomography for the diagnosis of cervical lesions on penetrating neck trauma and also identify the most frequent mechanisms of trauma. Most injured structures, determine the age range and the most prevalent sex. METHODS: observational descriptive retrospective study executed by the systematic retrospective review of medical records of all patients victims of penetrating neck trauma that went through surgery and CT scans, admitted into Hospital do Trabalhador, between January 2009 and December 2013...
July 2015: Revista do Colégio Brasileiro de Cirurgiões
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
B A H Vosse, A F van Belle, G J de Vries, M Das
Hemomediastinum is a rare pathological event. Multiple underlying causes and contributory factors can be identified, such as trauma, malignancy, iatrogenic, bleeding disorder or mediastinal organ hemorrhage. Also, a mediastinal bronchial artery aneurysm may be the source of a hemomediastinum. Hemoptysis is an important directive symptom, however occasionally, patients only present with thoracic pain or symptoms related to extrinsic compression of the airways or esophagus. Using contrast-enhanced computed tomography (CT) of the chest, hemomediastinum can be adequately diagnosed, and the involved vascular structures can be revealed...
2014: Respiratory Medicine Case Reports
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)
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