1/29. oral manifestations as a hallmark of malignant acanthosis nigricans.We present a case of malignant acanthosis nigricans (AN) that initially manifested in the oral cavity. In the present report, the patient had typical clinical and histological findings of oral and esophageal AN, with subtle skin changes, associated with a gallbladder adenocarcinoma. The importance of the clinical oral examination is emphasized because the recognition of oral lesions led to the diagnosis of AN and to the following detection of the internal malignancy. Since the tumours associated with AN are highly malignant, it is of the utmost importance to recognize the skin and mucous membrane changes in adults.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
2/29. Simplified access for division of the low cervical/high thoracic H-type tracheoesophageal fistula.H-type tracheoesophageal fistulas (H-TEF) often are located in the low cervical/high thoracic region where determination of the most appropriate surgical approach is difficult. When it can provide adequate exposure, a cervical incision is preferred because of the likelihood of decreased morbidity. A child with VACTERL association presented with recurrent respiratory problems. Esophagogram showed an H-TEF below the level of the clavicle. A vascular guide wire was placed through the H-TEF with the ends brought out through the mouth. Under fluoroscopic guidance, gentle traction was placed on the wire to bring the fistula into the neck for an easily accessible cervical exposure, thus eliminating the need for a thoracotomy.- - - - - - - - - - ranking = 0.21704591870814keywords = mouth (Clic here for more details about this article) |
3/29. Endoscopic and radiological features of intramural esophageal dissection.A 41-year-old woman was admitted to our hospital complaining of chest pain, dysphagia, and odynophagia after an upper respiratory tract infection and nasogastric tube insertion. An upper endoscopy showed a large submucosal bulge along the posterior wall from the upper esophagus with mucosal tears and bridge formation, extending down to the lower esophagus. A barium esophagogram revealed a "double-barreled" esophagus, and chest computed tomography (CT) scan showed eccentric thickening of the esophageal wall. The diagnosis of intramural esophageal dissection (IED) was made and the patient was managed conservatively with nothing by mouth and intravenous hydration. The clinical course was uneventful; the patient was discharged later and up to the time of writing has been completely asymptomatic, with normal swallowing function.- - - - - - - - - - ranking = 0.21704591870814keywords = mouth (Clic here for more details about this article) |
4/29. Perioperative management of a patient presenting with a spontaneously ruptured esophagus.PURPOSE: To report a case of spontaneous rupture of the esophagus and its anesthetic management. CLINICAL FEATURES: A 52-yr-old male presented with a seven day history of chest pain, respiratory distress, and swelling in the neck following forceful vomiting. Examination revealed hypotension, decreased air entry in the right lower lung field with crepitations, epigastric tenderness with abdominal distension and guarding of both right and left hypochondria. A contrast esophagogram showed extravasation of contrast material from the lower third of the esophagus into the mediastinum without pleural cavity involvement. Reinforced primary closure of a 5-cm transmural tear in the right anterolateral wall of the esophagus 5 cm above the gastro-esophageal junction was performed along with right-sided chest drainage. The anesthetic drugs and technique in this case were selected to avoid any increase in intra-abdominal pressure to prevent further spillage of gastric contents into the mediastinum through the perforation. Invasive monitoring was used to assess early hemodynamic changes and to administer fluid therapy and vasoactive drugs. Due to prolonged surgery, lung congestion, large fluid shifts, a long surgical incision and abnormal arterial blood gases, the patient was ventilated mechanically in the intensive care unit. Subsequently he developed an esophageal leak, septic shock, and multiple organ failure and died. CONCLUSION: In a patient with a spontaneous rupture of esophagus, the anesthetic considerations include avoidance of further aggravation of the esophageal tear, and resuscitation from a morbid inflammatory condition.- - - - - - - - - - ranking = 0.071164493110853keywords = cavity (Clic here for more details about this article) |
5/29. Boerhaave syndrome: a case report.Spontaneous rupture of the esophagus (Boerhaave syndrome) is a rare condition that has many possible causes, among them violent retching. The definitive treatment for the ruptured esophagus is surgical repair. Potential complications include infection in many forms, pleural effusion, and pneumothorax. This case study presents an overview of the syndrome, including morbidity, mortality, and treatment. The patient in this case is a 61-year-old man who had 1 episode of violent vomiting resulting in a perforation of the esophagus with communication into the right chest cavity. The patient underwent surgical repair of the rupture with placement of a feeding tube and creation of an esophageal diversion to promote healing of the surgical site.- - - - - - - - - - ranking = 0.071164493110853keywords = cavity (Clic here for more details about this article) |
6/29. Giant fibrovascular polyp of the esophagus. A lesion causing upper airway obstruction and syncope.Giant fibrovascular polyp of the esophagus is a rare but dramatic entity. These large polyps arise in the proximal esophagus and can cause airway obstruction secondary to mechanical pressure on the larynx, or they can present as a mass that is regurgitated into the oral cavity. We present a 66-year-old man who complained of nausea and vomiting that were associated with a fibrovascular polyp protruding into the mouth. He had also experienced several episodes of syncope resulting from intermittent airway obstruction. He underwent an open resection of an 11.8-cm fibrovascular polyp and an endoscopic resection of a second fibrovascular polyp 2 days later. Histopathologically, both masses were composed of a mixture of mature adipose tissue lobules and fibrovascular tissue, lined by reactive squamous epithelium. Despite their large size, giant fibrovascular polyps should be recognized radiologically and pathologically as benign lesions. However, they can result in significant morbidity.- - - - - - - - - - ranking = 1.2170459187081keywords = oral cavity, mouth, cavity (Clic here for more details about this article) |
7/29. Spontaneous esophageal rupture treated with staged operations.Spontaneous esophageal rupture is a life-threatening entity. Here, a 64-year-old male who presented with sudden onset of severe back pain was diagnosed as having an esophageal rupture to the right pleural cavity. Emergency operation was carried out 16 hours after the onset. The rupture was as large as 7 cm and the surrounding tissue was fragile and necrotic. We performed an esophagectomy as a primary salvage procedure. An esophageal reconstruction was carried out successfully 6 months after the initial operation. Staged operative strategy including esophagectomy is still an important option to treat this kind of high risk patient.- - - - - - - - - - ranking = 0.071164493110853keywords = cavity (Clic here for more details about this article) |
8/29. Concomitant esophageal and penile ulcerations healed with steroid therapy in a patient with AIDS: case report.A 50-year-old man with AIDS developed concomitant esophageal and penile ulcerations. An etiology could not be found despite intensive investigation. Both ulcers healed after treatment with corticosteroids. To our knowledge, such a situation has been described only for aphthous ulcerations involving the mouth, oropharynx, or esophagus.- - - - - - - - - - ranking = 0.21704591870814keywords = mouth (Clic here for more details about this article) |
9/29. Upper aerodigestive tract complications in a neonate with linear iga bullous dermatosis.linear iga bullous dermatosis (LABD) is a rare immunobullous condition known to affect the skin and mucous membranes of the eye and oral cavity in adults and young children. We describe a newborn with skin involvement who had life-threatening respiratory compromise from disease affecting the larynx, subglottis, trachea, and esophagus. Management with both tracheostomy and gastrostomy tube placement was necessary. Treatment included systemic steroids, dapsone, and intravenous immunoglobulin. We compare our neonatal case to the only other report in the literature highlighting involvement of the mucous membranes of multiple levels of the aerodigestive tract leading to respiratory compromise.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
10/29. Pyogenic granuloma: an unrecognized cause of gastrointestinal bleeding.Pyogenic granuloma is a lobular capillary hemangioma that mostly occurs on the skin, but it is also encountered on the mucosal surface of the oral cavity. Only a few cases in other parts of the digestive tract have been reported in Japanese patients. In this report, two Caucasian patients are described, who presented with gastrointestinal bleeding due to the presence of a pyogenic granuloma. One was located in the distal esophagus and could be treated with local excision and laser-photocoagulation therapy. The other one was located in the small intestine and was removed by surgical resection. Although extremely rare, pyogenic granuloma as a cause of gastrointestinal bleeding needs consideration. The lesion is benign, presumably reactive and can be adequately treated by excision or laser photocoagulation. immunohistochemistry and/or polymerase chain reaction for herpesvirus 8 can reliably distinguish pyogenic granuloma from Kaposi's sarcoma, an important differential diagnosis.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
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