1/58. colon interposition in a patient with total postcricoid stenosis after caustic ingestion and preservation of full laryngeal function.Caustic burns of the upper aerodigestive tract continue to be a significant clinical problem. However, the available literature uncommonly mentions changes affecting the larynx. We could find only one publication in which four cases of high hypopharyngeal stenosis were described in detail and where the functional outcome of the laryngeal function was stated as partially saved. We describe here a case of total retrocricoid stenosis in a 28-year-old woman that was caused by lye ingestion. A life-saving gastroesophagectomy was performed by the Department of general surgery. Reconstruction of the esophagus was carried out with mobilized right colon, which was meticulously sutured circumferentially behind the arytenoids and on the prevertebral fascia. The anatomy of the larynx and its nerve supply were scrupulously maintained intact. We believe that our patient's rehabilitation was due mainly to an intensive 18-month program of care, following which all laryngeal functions recovered with normal voice and swallowing patterns.- - - - - - - - - - ranking = 1keywords = esophagus (Clic here for more details about this article) |
2/58. Boerhaave-mimicking esophageal perforation with subsequent esophagobronchial fistula formation as the primary manifestation of Crohn's disease.BACKGROUND: Spontaneous ruptures of the esophagus are rare, but may lead to deleterious courses, even if diagnosed early. CASE REPORT: We report a case of Boerhaave's syndrome-mimicking esophageal perforation due to a stricture of the distal esophagus as the primary manifestation of Crohn's disease. diagnosis was delayed resulting in a complicated clinical course. The presented patient is the first case in the literature with esophageal perforation related to a previously undiagnosed Crohn's disease that lead to stenosis of the distal esophagus before becoming clinically apparent. CONCLUSION: Difficulties in differential diagnosis, problems related to initial misdiagnosis and consecutive mismanagment of spontaneous esophageal perforation, and treatment options including nonsurgical approaches are discussed.- - - - - - - - - - ranking = 3keywords = esophagus (Clic here for more details about this article) |
3/58. Dysphagia and thoracoabdominal aneurysm.Two elderly patients who presented with gradually progressive dysphagia are described. Investigations excluded an intraluminal obstruction and showed extrinsic compression of the oesophagus by an aneurysmal aorta. Surgery was not performed and they were successfully managed with a liquid diet.- - - - - - - - - - ranking = 1keywords = esophagus (Clic here for more details about this article) |
4/58. lichen planus involving the esophagus.lichen planus is a common mucocutaneus disorder that rarely involves the esophagus. We report two challenging cases presenting with recurrent dysphagia originally suspected due to gastroesophageal reflux. Subsequent evaluation revealed peculiar endoscopic findings of desquamative esophagitis leading to the diagnosis of lichen planus of the esophagus. This disorder should be considered in middle age or elderly women presenting with unexplained dysphagia or odynophagia. In this paper we review the available literature on the subject and summarize every case reported to date.- - - - - - - - - - ranking = 6keywords = esophagus (Clic here for more details about this article) |
5/58. Aggravation of the nutcracker syndrome during pregnancy.BACKGROUND: The nutcracker syndrome is a rare condition thought to be caused by compression of the left renal vein between the descending aorta and the superior mesenteric artery. CASE: Gross hematuria appeared in the third trimester of an otherwise normal pregnancy. It continued despite treatment, and a cesarean was performed at 37 weeks' gestation. The hematuria stopped postpartum. With postpartum angiography and three-dimensional computed tomography, the diagnosis of nutcracker syndrome was finally made. CONCLUSION: pregnancy can aggravate the nutcracker syndrome. This syndrome should be recognized as one of the diseases that causes gross hematuria.- - - - - - - - - - ranking = 8949.9544142302keywords = nutcracker (Clic here for more details about this article) |
6/58. Clinitest burns of the esophagus.Five children developed esophageal stricture from the ingestion of a Clinitest tablet. The sodium hydroxide contained in these tablets induced a short, dense stricture that was resistant to dilation and necessitated resection. In all patients primary esophageal resection with end-to-end anastomosis was technically possible. Four of the patients needed two or more dilations postoperatively and 1 still requires dilation. Prevention of accidental ingestion by use of a childproof container and parental education about the caustic nature of Clinitest are both essential to eliminate this child health hazard.- - - - - - - - - - ranking = 4keywords = esophagus (Clic here for more details about this article) |
7/58. Extrinsic left atrial compression in a patient with achalasia.Left atrial compression by the esophagus, the stomach, or both is an uncommon but important cause of hemodynamic compromise. Achalasia is a disease of the esophagus with dilatation of the distal part and constriction of the lower oesophageal sphincter. Dilated esophagus is a rare cause of left atrial compression. Timely and precise diagnosis is of paramount importance in cases of left atrial compression and echocardiography enables clinicians to make a differential diagnosis successfully in most cases. Correction of primary pathology will usually lead to the return of normal hemodynamic function. We describe a case of extrinsic left atrial compression caused by the dilated esophagus due to achalasia that caused paroxysms of atrial tachycardia and hemodynamic compromise.- - - - - - - - - - ranking = 4keywords = esophagus (Clic here for more details about this article) |
8/58. Difficult placement of Univent tube blocker due to aberrant right subclavian artery aneurysm.There have been few reports on aneurysms of the anomalous branch of the aortic arch. We present a rare case in which correct placement of the movable blocker of a Univent tube was difficult due to an aberrant right subclavian artery aneurysm. A 72-year-old man with a history of hypertension had manifested coughing and wheezing for four months prior to admission to our hospital. A chest computed tomogram revealed that his aortic arch had four branches and that the right subclavian artery did not originate from the first branch, but was the fourth branch. The angiogram disclosed that an aneurysm had developed in the anomalous artery close to the aorta, and behind the other three branches, trachea, and esophagus. The aneurysm not only had pushed the trachea out of place but was also pressing against it. After anesthetic induction, his trachea was intubated using an endotracheal tube with a movable blocker, the Univent tube, for single-lung ventilation. The blocker could not be advanced into the left main bronchus due to the tracheal deviation caused by the aneurysm. Several methods of blocker placement, including those recommended in the manual attached to the product, were attempted without success. Finally, the trachea was intubated again using a Univent tube with the blocker tip bent manually, which permitted entrance of the blocker into the bronchus. Blocker placement should be modified to suit patients with a problem in the trachea or bronchi.- - - - - - - - - - ranking = 1keywords = esophagus (Clic here for more details about this article) |
9/58. Nutcracker syndrome: an overlooked cause of hematuria.Nutcracker syndrome is caused by compression of the left renal vein between the aorta and the superior mesenteric artery, where it courses in the fork formed at the bifurcation of these arteries. The phenomenon results in left renal venous hypertension, which leads to left renal vein and left gonadal vein varices and unilateral hematuria. The main presenting symptom is hematuria, with or without left flank pain. The disorder is easily missed by routine diagnostic methods. Its incidence is likely underestimated. We report on a 25-year-old woman who experienced intermittent gross hematuria and left flank pain. The diagnosis of nutcracker syndrome was missed initially. Abdominal computed tomography, angiography, venography, and magnetic resonance angiography, which were later performed, showed that the left renal vein was compressed between the aorta and the superior mesenteric artery. The pressure gradient between the left renal vein and the inferior vena cava was 6.8 cm H2O. A diagnosis of nutcracker syndrome was established. She refused surgery and was lost to follow-up. The diagnosis and treatment of nutcracker syndrome are discussed. magnetic resonance angiography is a safe and reliable tool for diagnosing this disorder.- - - - - - - - - - ranking = 3835.6947489558keywords = nutcracker (Clic here for more details about this article) |
10/58. Achalasia cardia and gastric outlet stenosis in a postmenopausal woman: case report.The orderly contractility of the oesophagus and the regulated ability of the pyloric sphincter allow the influx and efflux of gastric contents. When these physiological processes are impaired, gastric luminal transit is altered as expected in achalasia cardia and gastric outlet obstruction. movement across the inlet and outlet of the stomach is therefore altered. A case of a 58-year old woman diagnosed with simultaneous occurrence of achalasia cardia and gastric outlet stenosis resulting from chronic duodenal ulcer is presented. The diagnosis was based on clinical, radiological and intraoperative findings. This patient has remained well after a simultaneous anterior cardiomyotomy and H-M pyloroplasty. To my knowledge this is the first time that such an association causing gastric "inlet" and "outlet" obstruction has been reported.- - - - - - - - - - ranking = 1keywords = esophagus (Clic here for more details about this article) |
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