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Esophagic perforation

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https://www.readbyqxmd.com/read/28631201/seven-esophageal-perforation-cases-after-aortic-replacement-stenting-for-thoracic-aortic-dissection-or-aneurysm
#1
Yoshihisa Yaguchi, Yoshimasa Kumata, Masahiro Horikawa, Takashi Kiyokawa, Tsuyoshi Inaba, Ryoji Fukushima
BACKGROUND: Esophageal perforation after aortic replacement/stenting for aortic dissection or aneurysm is a rare but severe complication. However, its cause, standard treatment, and prognosis are unclear. We analyzed the treatment and outcome retrospectively from seven cases experienced at our hospital. CASE PRESENTATION: The median age of the patients was 70 years (range, 41-86), and six of the seven cases were male. As the first treatment, aortic replacement techniques were performed in five, and thoracic endovascular aortic repair (TEVAR) procedure was performed in two...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28619542/development-of-a-multidisciplinary-program-to-expedite-care-of-esophageal-emergencies
#2
DuyKhanh P Ceppa, Carlo Maria Rosati, Lola Chabtini, Samantha M Stokes, Holly C Cook, Karen M Rieger, Thomas J Birdas, John C Lappas, William R Kessler, John M DeWitt, Dean D Maglinte, Kenneth A Kesler
BACKGROUND: Level 1 programs have improved outcomes by expediting the multidisciplinary care of critically ill patients. We established a novel level 1 program for the management of esophageal emergencies. METHODS: After institutional review board approval, we performed a retrospective analysis of patients referred to our level 1 esophageal emergency program from April 2013 through November 2015. A historical comparison group of patients treated for the same diagnosis in the previous 2 years was used...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28616404/complications-following-endoscopic-submucosal-dissection-for-gastric-esophageal-and-colorectal-cancer-a-review-of-studies-based-on-nationwide-large-scale-databases
#3
REVIEW
Hiroyuki Odagiri, Hideo Yasunaga
Endoscopic submucosal dissection (ESD) is a relatively new procedure used for the treatment of early gastrointestinal cancers regardless of the lesion size and configuration, and it has gradually acquired popularity because of its minimally invasive nature. As compared to conventional endoscopic resection, ESD is a more complex procedure and requires a higher level of technical skill. Therefore, it is associated with a higher complication rate. Many previous studies that investigated the complication rates following ESD analyzed data from a limited number of specialized centers, possibly leading to an underestimation of the complication rates...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28616399/management-of-strictures-after-endoscopic-submucosal-dissection-for-superficial-esophageal-cancer
#4
REVIEW
Koichiro Kawaguchi, Hiroki Kurumi, Yohei Takeda, Kazuo Yashima, Hajime Isomoto
Endoscopic resection of early esophageal cancer has a high therapeutic effect while being minimally invasive. Especially, the establishment of the endoscopic submucosal dissection (ESD) procedure has made it possible to resect large lesions in an en-bloc manner. As a result, accurate pathology evaluation became possible, and the risk of local recurrence was extremely low. On the other hand, esophageal strictures after endoscopic treatment of an extensive circumferential lesion are a potential problem. Previously, for the prevention and treatment of esophageal strictures, patients had to undergo painful endoscopic balloon dilation (EBD) many times...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28616296/traumatic-esophageal-perforation-by-a-self-bougienage
#5
Eung-Soo Kim, Jong-Yael Kang, In-Soo Cho, Gwang-Woo Rhee
The case report describes a 75-year-old female with esophageal perforation by a self bougienage. From a decade ago, she had performed an esophageal bougienage by herself with a 70 cm long self-made bougie whenever she suffered from food impaction. On the day of the accident, she went on an outing without carrying the bougie, she pushed a broken bough into her esophagus, eventually the bough perforated her thoracic esophagus. We found some food particles in a large mediastinal abscess cavity, and the perforated esophagus was repaired by interrupted sutures and reinforced with a pedicled intercostal musculopleural flap...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28602724/achalasia-treatment-outcomes-utilization-and-costs-a-population-based-study-from-the-united-states
#6
Anne P Ehlers, Brant K Oelschlager, Carlos A Pellegrini, Andrew S Wright, Michael D Saunders, David R Flum, Hao He, Farhood Farjah
OBJECTIVE: Randomized trials show that pneumatic dilatation ≥30mm (PD) and laparoscopic myotomy (LM) provide equivalent symptom relief and disease-related quality of life for patients with achalasia. However, there remain questions about the safety, burden, and costs of treatment options. METHODS: We performed a retrospective cohort study of achalasia patients initially treated with PD or LM (2009-2014) using the Truven Health MarketScan® Research Databases. All patients had one year of follow-up after initial treatment...
June 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28593788/a-complication-following-a-biopsy-sample-in-eosinophilic-esophagitis
#7
Antonio Cerezo Ruiz, Encarnación Parras Mejías, José María Martos Becerra
We present a case of a young 16 year old patient that had an esophageal perforation in the context of eosinophilic esophagitis. The esophagus showed vertical lacerations and mucosal thickness on endoscopy, thus a biopsy was performed in the proximal section which resulted in profuse bleeding due to a deep mucosal tear. A subsequent computed tomography scan revealed a perforation. Due to the absence of symptoms the patient was managed conservatively. The patient was discharged within 48 hours after admission...
June 8, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28588368/two-cases-of-esophageal-injury-following-anterior-cervical-discectomy-and-fusion-one-overt-and-one-covert
#8
Prasad Krishnan, Rajaraman Kartikueyan, Sachinkumar Maheshbhai Patel, Partha Pratim Bose, Kanchan Kumar Mukherjee
Esophageal perforation is a dreaded complication of anterior cervical spinal surgery. A 52-year-old diabetic man had undergone a surgery for a C6-C7 disc prolapse and developed spiking fever with chills and rigor on the 7th postoperative day. No cause could be found out but a CT scan of thorax done in the course of investigations revealed pneumomediastimum. The patient succumbed on the 10th day after surgery. Autopsy revealed the cause of death to be mediastinitis following iatrogenic esophageal perforation...
May 2017: Annals of Neurosciences
https://www.readbyqxmd.com/read/28587747/flexible-endoscopic-diagnosis-and-treatment-of-esophageal-stenosis-in-children-with-noninvasive-ventilation-support
#9
Kao-Hsian Hsieh, Wen-Jue Soong, Mei-Jy Jeng, Yu-Sheng Lee, Pei-Chen Tsao, Ya-Ling Chou
BACKGROUND: Esophageal stenosis (ES) is characterized by dysphagia, failure to thrive, and long-term disability. It requires repeated management because it is refractory. Traditionally, these procedures are performed under general anesthesia with airway intubation. PURPOSE: This study investigated the safety and efficacy of the management of interventional flexible endoscopy (IFE) performed with a novel noninvasive ventilation (NIV) support. METHODS: Use of a short-length flexible endoscope with NIV of pharyngeal oxygen, nose closure, and abdominal compression during IFE was investigated...
May 10, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28577842/a-nationwide-rise-in-the-use-of-stents-for-benign-esophageal-perforation
#10
Lucas W Thornblade, Aaron M Cheng, Douglas E Wood, Michael S Mulligan, Michael D Saunders, Hao He, Brant K Oelschlager, David R Flum, Farhood Farjah
BACKGROUND: Surgical repair or drainage is the standard treatment for benign esophageal perforation. The United States Food and Drug Administration has approved the use of esophageal stents for the management of malignant esophageal stricture or fistula, or both. We hypothesize that increasing enthusiasm and experience with esophageal stents has led to greater use of stents for the management of benign esophageal perforation. METHODS: We performed a retrospective cohort study (2007 to 2014) of patients with benign esophageal perforation using MarketScan (Thomson Reuters, New York, NY), a commercial claims database...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28575246/safety-and-feasibility-of-esophageal-self-expandable-metal-stent-placement-without-the-aid-of-fluoroscopy
#11
S Saligram, D Lim, L Pena, M Friedman, C Harris, J Klapman
Self-expandable metal stents (SEMSs) are used for the management of certain esophageal conditions such as strictures, perforations, and fistulae. These can be placed using fluoroscopic control, endoscopic control, or a combination of both. We evaluated our institutional experience of placing a SEMS using only endoscopy without the aid of fluoroscopy to determine safety and feasibility using this technique. A retrospective review was performed to identify all patients who underwent esophageal SEMS from January 2010 to June 2015...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28575240/epidemiology-diagnosis-and-management-of-esophageal-perforations-systematic-review
#12
E Ilias K Sdralis, S Petousis, F Rashid, B Lorenzi, A Charalabopoulos
We performed a systematic review of epidemiological, diagnostic, and therapeutic outcomes of esophageal perforations. A systematic review was performed in PubMed database using the key-phrase 'esophageal perforation'. All studies regarding acute esophageal perforations were reviewed and parameters of epidemiology, diagnosis, and management published in the literature from 2005 up to 2015 were included in the study. Studies of postoperative esophageal leaks were excluded. Two researchers performed individually the research, while quality assessment was performed according to GRADE classification...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28566899/severe-esophageal-injury-after-radiofrequency-ablation-a-deadly-complication
#13
Nurit Katz-Agranov, Moises I Nevah Rubin
Various degrees of esophageal injury have been described after radiofrequency ablation performed for treatment of atrial fibrillation. The main mechanism of injury is thermal and may lead to a range of esophageal mucosal changes, some clinically insignificant, however when deep ulceration occurs, this may be further complicated by perforation and mediastinitis, a rare but life threatening sequelae. We present a case of a severe esophageal injury leading to mediastinitis, with interesting endoscopic findings...
May 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28550876/neonatal-and-pediatric-esophageal-perforation
#14
Rebecca M Rentea, Shawn D St Peter
Esophageal perforation (EP) is a rare complication that is often iatrogenic in origin. In contrast with adult patients in whom surgical closure of the defect is preferred, nonoperative treatment has become a common therapeutic approach for EP in neonates and children. Principles of management pediatric EP includes rapid diagnosis, appropriate hemodynamic monitoring and support, antibiotic therapy, total parenteral nutrition, control of extraluminal contamination, and restoration of luminal integrity either through time or operative approaches...
April 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28536813/long-term-outcomes-of-heller-s-myotomy-and-balloon-dilatation-in-childhood-achalasia
#15
Efstratios Saliakellis, Nikhil Thapar, Derek Roebuck, Fernanda Cristofori, Kate Cross, Edward Kiely, Joseph Curry, Keith Lindley, Osvaldo Borrelli
Achalasia is a rare esophageal motility disorder: its optimal treatment in children is still a matter of debate. Records of children treated for achalasia, over an 18-year period, were reviewed.Forty-eight children (median age at diagnosis 10 years; range 3-17 years) were identified. Twenty-eight patients were initially treated with Heller's myotomy (HM) and 20 with balloon dilatation (BD). At last follow-up (median 3 years; range 1-5.5 years), 43.8% (21/48) of children were symptom free. The number of asymptomatic children was significantly higher among those treated initially with HM compared to BD (HM 15/28, 53...
May 23, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28534330/-preliminary-results-of-submucosal-tunneling-endoscopic-septum-division-in-the-treatment-of-esophageal-diverticulum
#16
Mingyan Cai, Meidong Xu, Quanlin Li, Weifeng Chen, Yan Zhu, Danfeng Zhang, Liqing Yao, Pinghong Zhou
OBJECTIVE: To evaluate the safety and efficacy of submucosal tunneling endoscopic septum division (STESD) for escophageal diverticulum. METHODS: Clinical data of six consecutive patients with symptomatic esophageal diverticula who received STESD in Endoscopy Center of Zhongshan Hospital, Fudan University from April 2016 to November 2016 were analyzed retrospectively. STESD was performed as following: mucosal entry was made 3 cm from the septum of esophageal diverticulum; submucosal tunnel was created towards the septum; after the satisfactory exposure of the septum, endoscopic division was made down to the bottom of the diverticulum; mucosal closure of the tunnel entry was made...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28530769/beneficial-effects-of-garlic-allium-sativum-oil-in-experimental-corrosive-esophageal-burns-effects-of-garlic-oil-in-esophageal-burns
#17
Ceren Şen Tanrıkulu, Yusuf Tanrikulu, Fahriye Kılınç, Burak Bahadır, Murat Can, Füruzan Köktürk
BACKGROUND: Corrosive esophageal burns, particularly common in developing countries, lead to different problems in different age groups. The ingestion of corrosive substances can cause such problems as stricture of the esophagus, to acute perforation, and even death. Because stricture formation is related to the severity of the initial injury, the prevention of stricture constitutes a main goal of treatment. The aim of this study was to investigate the protective and anti-inflammatory effects of garlic (Allium sativum) oil in corrosive esophageal burn...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28528074/skin-perforator-flap-pedicled-by-intercostal-muscle-for-repair-of-a-tracheobronchoesophageal-fistula
#18
Nicolas Bertheuil, Caterina Cusumano, Cécile Meal, Yann Harnoy, Eric Watier, Bernard Meunier
A tracheobronchial fistula (TBF) is a rare complication when an operation is performed to treat esophageal carcinoma; no consensus treatment strategy has emerged. We describe a surgical interposition strategy, using a new flap, to repair a TBF that arose when esophageal squamous cell carcinoma was treated with neoadjuvant chemoradiation and minimally invasive esophagectomy (the 3-stage McKeown procedure). We performed a skin perforator flap pedicled by the intercostal muscle. It is a valuable option that may be the optimal first-line treatment, especially in the context of neoadjuvant radiation therapy...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527963/clinical-significance-of-spontaneous-pneumomediastinum
#19
Brittany A Potz, Linda H Chao, Thomas T Ng, Ikenna C Okereke
BACKGROUND: Spontaneous pneumomediastinum (SPM) is classified as free air in the mediastinum in the absence of any precipitating cause. It is relatively uncommon, and the clinical significance and risk associated with SPM is not well understood and has not been widely documented in the literature. Our goals were to determine the outcomes of patients who presented with SPM and to determine predictors of severe pathology associated with SPM. METHODS: From 2004 through 2013, a retrospective review was conducted of patients who presented with SPM to our institution...
May 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28510809/transcatheter-arterial-embolization-for-intercostal-arterio-esophageal-fistula-in-esophageal-cancer
#20
Tetsuya Tajima, Shigeo Haruki, Shinsuke Usui, Koji Ito, Akiyo Matsumoto, Akiyuki Matsuhisa, Noriaki Takiguchi
BACKGROUND: While esophageal fistula formation in the adjacent organs is associated with high rates of morbidity and mortality, the management of non-aortic arterio-esophageal fistula has not been frequently reported. CASE PRESENTATION: A 69-year-old Japanese man who had undergone definitive chemoradiotherapy for esophageal cancer was admitted to our hospital with hematemesis. He was diagnosed with mediastinal abscess caused by esophageal perforation, and esophageal bypass surgery was performed...
December 2017: Surgical Case Reports
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