1/3. Surgical treatment of recalcitrant radiation-induced gastric erosions.BACKGROUND: Uncontrolled bleeding as a result of radiation gastritis in patients who have pharyngo-laryngo-esophagectomy and gastric pull-up is seldom reported. Surgical resection in the management of this condition has rarely been described. METHOD: A 66-year-old man with hypopharyngeal cancer was treated by pharyngo-laryngo-esophagectomy and gastric transposition. He received postoperative radiotherapy and had recurrent hemorrhagic gastritis, necessitating surgical resection. The manubrium was resected to access the mediastinal part of the gastric conduit. The diseased part of the gastric conduit was removed and a free jejunal graft was interposed to replace the resected stomach. RESULTS: Manubrial resection offered adequate access to the stomach transposed in the mediastinum, and the life-threatening bleeding gastritis was successfully controlled by surgical resection. CONCLUSION: Surgical resection of the radiation-damaged transposed stomach through a manubrial resection approach can safely be performed. Free jejunal graft is the choice of reconstruction of the circumferential defect.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/3. Histopathological examination of ruptured carotid artery after irradiation.We report 2 cases of carotid artery rupture after irradiation that was performed 1 year and 17 years before the ruptures. When irradiation-induced arterial rupture occurs, it usually does so within a few months following irradiation. However, the histopathological sections obtained in the present cases revealed carotid artery necrosis that was presumably induced by irradiation. Carotid artery rupture is sudden, massive hemorrhage that ranks among the most dreaded complications in the head and neck. However, several patients have been saved by hospital personnel who discovered the rupture in time to take appropriate measures such as cleaning of the wound and protection with myocutaneous or myofascial flaps. Therefore, it is important to be aware of the possibility of rupture or perforation of major vessels after irradiation, even when the radiation therapy was performed a long time ago.- - - - - - - - - - ranking = 0.25keywords = radiation-induced (Clic here for more details about this article) |
3/3. Treatment of a radiation-induced esophageal web with retrograde esophagoscopy and puncture.OBJECTIVE: To present a technique for the treatment of complete esophageal stenosis in the post-radiation patient that may be applied to selected patients with obstructing stenoses. STUDY DESIGN: A case report of the treatment of a post-radiation esophageal web. methods: A review of the patient's history of treatment and a discussion of reported treatment options. RESULTS: A complete obstruction of the cervical esophagus was diagnosed in a patient after chemoradiation for a hypopharyngeal carcinoma. Retrograde esophagoscopy through the patient's percutaneous endoscopic gastrostomy tube site aided visualization and perforation of the obstructing tissue. Subsequent dilation has allowed the patient to resume oral intake of a regular diet without restrictions. CONCLUSION: Combined direct laryngoscopy with retrograde esophagoscopy represents a viable alternative to more extensive approaches for recannulization of selected obstructing esophageal stenoses.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |