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Maxwel Capsy Boga Ribeiro, Amanda Bueno de Araújo, Juverson Alves Terra-Júnior, Eduardo Crema, Nelson Adami Andreollo
Background: Surgical treatment of GERD by Nissen fundoplication is effective and safe, providing good results in the control of the disease. However, some authors have questioned the efficacy of this procedure and few studies on the long-term outcomes are available in the literature, especially in Brazil. Aim: To evaluate patients operated for gastro-esophageal reflux disease, for at least 10 years, by Nissen fundoplication. Methods: Thirty-two patients were interviewed and underwent upper digestive endoscopy, esophageal manometry, 24 h pH monitoring and barium esophagogram, before and after Nissen fundoplication...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Han Deng, Xingshun Qi, Xiaozhong Guo
OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of contrast-enhanced computed tomography (CT) for varices in liver cirrhosis. METHODS: PubMed and EMBASE databases were searched for the literature identification. The area under the summary receiver operating characteristic curve (AUSROC), sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), and diagnostic odds ratio (DOR) were calculated. We performed the subgroup analyses according to the location of varices, CT technique, and study design...
October 8, 2016: Postgraduate Medicine
Amani Jambhekar, Amy Maselli, Ryan Lindborg, Krystyna Kabata, Anthony Tortolani, Piotr Gorecki
BACKGROUND AND OBJECTIVES: Prior studies have established a 1.7-4.33% readmission rate for laparoscopic sleeve gastrectomy (LSG), a rate that falls within the reported range for other bariatric procedures. The current report describes the incidence of 30-day readmission after primary LSG procedures performed at a single bariatric center of excellence (COE) and examines factors that may be associated with readmission. METHODS: Data on 343 consecutive LSG operations performed from February 2010 to May 2014 by a single surgeon (PG) were analyzed...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Madhusudhan R Sanaka, Ramprasad Jegadeesan, Prashanthi N Thota, Udayakumar Navaneethan, Rocio Lopez, Sudish C Murthy, Siva Raja
Background and Aims. We initiated peroral endoscopic myotomy (POEM) utilizing a two-person technique with combination of an advanced endoscopist and a thoracic surgeon with complementary skills. Our aim was to determine the feasibility and outcomes in initial 20 patients. Methods. In this observational study, main outcomes measured were therapeutic success in relieving symptoms (Eckardt score < 3), decrease in lower esophageal sphincter (LES) pressures, improvement in emptying on timed barium esophagogram (TBE), and complications...
2016: Canadian Journal of Gastroenterology & Hepatology
Daniel Ross, Joel Richter, Vic Velanovich
The diagnosis of achalasia is generally made based on patient symptoms, the appearance of the esophagus on endoscopy and barium esophagogram, and esophageal manometry. In addition, timed barium esophagography (TBE) can give useful information on the clearance of liquid barium over a 10 minute period and the passage of a barium tablet. What is unclear is how well these physiological measurements of esophageal function correlate with patient-perceived health-related quality of life. Our aim was to assess whether objective physiological measurements of high-resolution manometry (HRM) and TBE will correlate with quantitative achalasia-related health-related quality of life (HRQoL) measurements...
September 15, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Emmanuel Akintoye, Nitin Kumar, Itegbemie Obaitan, Quazim A Alayo, Christopher C Thompson
Background and study aim: Peroral endoscopic myotomy (POEM) is a relatively novel minimally invasive technique that is used to treat achalasia and other esophageal motility disorders. We systematically reviewed the medical literature in order to evaluate the safety and efficacy of POEM. Methods: We performed a comprehensive review and meta-analysis of studies published up to March 2016 that reported on clinical outcomes of POEM. Five databases were searched: MEDLINE, EMBASE, Ovid, CINAHL, and Cochrane. Results: A total of 36 studies involving 2373 patients were included in the review...
September 12, 2016: Endoscopy
Xinwei Han, Lei Li, Yanshi Zhao, Chao Liu, Dechao Jiao, Kewei Ren, Gang Wu
BACKGROUND: Thoracogastric airway fistula (TGAF) is a rare and dangerous complication of esophagectomy performed for esophageal and cardiac carcinomas. Herein, we aimed to explore the feasibility and efficacy of individualized airway stent implantation for the treatment of TGAF after esophagectomy. METHODS: Based on different TGAF types and relevant data on chest computed tomography, customized airway-covered stents were positioned so as to cover the entrance to the fistula by an interventional radiologist using fluoroscopic guidance...
August 12, 2016: Surgical Endoscopy
F A Ponds, A J Bredenoord, B F Kessing, A J P M Smout
BACKGROUND: Manometric criteria to diagnose achalasia are absent peristalsis and incomplete relaxation of the esophagogastric junction (EGJ), determined by an integrated relaxation pressure (IRP) >15 mm Hg. However, EGJ relaxation seems normal in a subgroup of patients with typical symptoms of achalasia, no endoscopic abnormalities, stasis on timed barium esophagogram (TBE), and absent peristalsis on high-resolution manometry (HRM). The aim of our study was to further characterize these patients by measuring EGJ distensibility and assessing the effect of achalasia treatment...
July 25, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Masahito Aimi, Hironobu Mikami, Daisuke Izumi, Eiko Okimoto, Yasumasa Tada, Tsuyoshi Mishiro, Norihisa Ishimura, Shunji Ishihara, Yoshikazu Kinoshita
Esophageal intramural pseudo-diverticulosis (EIPD) is a rare disease characterized by multiple small flask-shaped pouches in the esophageal wall, with the predominant symptom of chronic progressive or intermittent dysphagia. However, its etiology and pathogenesis remain unknown. We present a case of EIPD evaluated with high-resolution manometry in a 75-year-old man with food impaction after eating beef, who came to our emergency department. The patient experienced similar episodes three times previously, though the cause was unknown...
October 2016: Clinical Journal of Gastroenterology
Farhad Malek, Hossein Nobakhat, Hamidreza Hemmati
There is little mention in the literature about achalasia as an etiologic factor of Bronchiolitis obliterans organizing pneumonia (BOOP). In this study, a case of BOOP, which appeared to be secondary to achalasia is reported. A 35 years old man present with nonproductive cough, chills and fever from two month ago. Due to permanent consolidation in mid zone of right lung and unresponsive to antibiotics, transthoracic needle biopsy was done that showed BOOP. Due to esophageal dilatation in chest computerized tomography (CT) scan, endoscopy and esophagogram was done that showed achalasia...
2016: Respiratory Medicine Case Reports
Sankalp Dwivedi, E Brooke Schrickel, Fayez Siddiqui, John O'Brien, James Kruer
A 42-year-old male presented with worsening gastroesophageal reflux disease symptoms and cough. The clinical symptoms during the early course of illness were striking for aspiration pneumonia. He was given a prescription of proton pump inhibitors and antibiotics. Rapid decline in the clinical condition with worsening respiratory status was noted. Worsening symptoms of fever, cough, and chest pain prompted further diagnostic work-up suggesting esophageal microperforation. Esophagogram was found to be suggestive of tracheoesophageal fistula...
2016: Case Reports in Gastrointestinal Medicine
Vishesh Jain, Devendra Kumar Yadav, Shilpa Sharma, Manisha Jana, Devendra Kumar Gupta
Congenital esophageal stenosis (CES) is a rare cause of dysphagia in children. Diagnosis is often apparent on esophagogram. Surgical treatment for the subtype with tracheobronchial remnants (TBR) includes resection and anastomosis of the stenosed segment, myectomy, enucleation of cartilage, etc., These procedures are not suitable if the stenosed segment is long. We present a case of a 5-year-old boy who was diagnosed as CES and was successfully managed with stricturoplasty with some innovative modifications...
July 2016: Journal of Indian Association of Pediatric Surgeons
Mohammad Amani, Narges Fazlollahi, Shapour Shirani, Reza Malekzadeh, Javad Mikaeli
UNLABELLED: BACKGROUND Although Heller myotomy is one of the most effective treatments for achalasia, it may be associated with early or late symptom relapse in some patients. Therefore, additional treatment is required to achieve better control of symptoms. AIM: To evaluate the safety and efficacy of pneumatic balloon dilation (PBD) in patients with symptom relapse after Heller myotomy. METHODS Thirty six post-myotomy patients were evaluated from 1993 to 2013. Six patients were excluded from the analysis because of comorbid diseases or epiphrenic diverticula...
January 2016: Middle East Journal of Digestive Diseases
Claudia Barone, Nicolina Stefania Carucci, Claudio Romano
Dysphagia is an impairment of swallowing that may involve any structures from the mouth to the stomach. Esophageal dysphagia presents with the sensation of food sticking, pain with swallowing, substernal pressure, or chronic heartburn. There are many causes of esophageal dysphagia, such as motility disorders and mechanical and inflammatory diseases. Infrequently dysphagia arises from extrinsic compression of the esophagus from any vascular anomaly of the aortic arch. The most common embryologic abnormality of the aortic arch is aberrant right subclavian artery, clinically known as arteria lusoria...
2016: Case Reports in Pediatrics
Iftikhar Ahmad Jan, Asma Al Nuaimi, Basma Al Hamoudi, Khalid Al Naqbi, Mohammad Bilal
Esophageal duplication cysts are rare congenital abnormalities of the foregut and may be associated with other conditions. Association of esophageal duplication with Gastro-Esophageal Reflux Disease (GERD) has not been reported in children. We are reporting a case of a 16 months baby who had antenatal diagnosis of diaphragmatic hernia. Postnatal CTchest, however, suggested a distal esophageal duplication cyst and a contrast esophagogram showed grade-IV GER. A thoracoscopy in another hospital excluded esophageal duplication at that time...
February 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Monika Bawa, Prema Menon, Jai K Mahajan, Nitin J Peters, Saurabh Garge, K L N Rao
AIMS: To investigate the role of feeding jejunostomy (FJ) in patients of esophageal atresia with anastomotic leak (AL) to decrease the degree of gastroesophageal reflux (GER) and its effect on anastomotic healing. MATERIALS AND METHODS: Twenty neonates, with major AL and severe GER after primary repair were managed with decompressing gastrostomy and transgastric FJ and analyzed prospectively. RESULTS: Male to female ratio was 1.7:1. Mean birth weight was 2...
January 2016: Journal of Indian Association of Pediatric Surgeons
Adrián Sánchez-Montalvá, María Moris, Marianela Mego, Fernando Salvador, Anna Accarino, Kathleen Ramírez, Fernando Azpiroz, Antonio Ruiz-de-Leon, Israel Molina
INTRODUCTION: Gastrointestinal involvement affects 30-40% of the patients with chronic Chagas disease. Esophageal symptoms appear once the structural damage is established. Little is known about the usefulness of high resolution manometry to early identification of esophageal involvement. METHOD: We performed a cross-sectional study at the Vall d'Hebron University Hospital (Barcelona, Spain) between May 2011 and April 2012. Consecutive patients diagnosed with Chagas disease in the chronic phase were offered to participate...
February 2016: PLoS Neglected Tropical Diseases
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
José Luis Braga de Aquino, José Francisco Salles Chagas, Marcelo Manzano Said, Maria Beatriz Nogueira Pascoal, Luis Antonio Brandi-Filho, Douglas Alexandre Rizzanti Pereira, Fernanda Fruet
BACKGROUND: The occurrence of the pharyngoesophageal, or Zenker diverticulum is not frequent in the national scenario, and the technique of the diverticulectomy with cricomyotomy in medium and great dimension diverticula is still the most indicated. Because the resection of the diverticulum requires the suture of the pharynx, dehiscence can occur, thereafter delaying swallowing. Hence, the idea is to accomplish this surgical procedure, comparing the manual and mechanical suture, in order to evaluate the real benefit of the mechanical technique...
November 2015: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
H U De Schepper, F A M Ponds, J M Oors, A J P M Smout, A J Bredenoord
BACKGROUND: According to the Chicago classification of esophageal motility disorders, distal esophageal spasm (DES) is defined as premature esophageal contractions (distal latency [DL] <4.5 s) for ≥20% of swallows, in the presence of a normal mean integral relaxation pressure (IRP). However, some patients with symptoms of DES have rapid contractions with a normal DL. The aim of this study was to characterize these patients and compare their clinical characteristics to those of patients classified as DES...
February 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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