Cases reported "Constriction, Pathologic"

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1/39. 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.
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ranking = 1
keywords = esophagus
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2/39. 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.
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ranking = 3
keywords = esophagus
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3/39. 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.
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ranking = 1
keywords = esophagus
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4/39. 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.
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ranking = 6
keywords = esophagus
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5/39. 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.
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ranking = 4
keywords = esophagus
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6/39. 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.
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ranking = 4
keywords = esophagus
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7/39. 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.
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ranking = 1
keywords = esophagus
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8/39. 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.
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ranking = 1
keywords = esophagus
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9/39. Y-nitinol airway stent for management of central airway compression due to metastatic colon cancer.

    Tumor masses in the area between the esophagus and the tracheobronchial tree can lead to complications involving both systems, mainly strictures and compressions. Malignant esophageal strictures are nowadays often treated by insertion of a metal stent which, however, can cause airway compression especially in the proximal area. We present here a new method of creating a Y-stent out of two self-expandable tracheal nitinol stents, utilizing fiber bronchoscopy, in a 55-year-old woman with advanced colon cancer metastastic to the mediastinum. The endo-Y-stent technique can be performed with the patient under sedation and having topical anesthesia. The opening through which the second tracheal stent must be placed for the Y construction is created by laser. In this case, the patient suffered from airway compression which was efficiently relieved by this method. Within a short time the endo-Y-stent provides effective restoration and maintenance of airway patency in patients with tumor compression in the region of the esophagus and airway, and in those with airway compression following esophageal stenting. Expertise in both stent implantation and laser application is, however, mandatory.
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ranking = 2
keywords = esophagus
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10/39. Supergastrinoma: simultaneous peptic ulceration of esophagus, stomach, and small intestine.

    Synchronous involvement of the esophagus, stomach, and small intestine by peptic ulceration has not been previously described in the zollinger-ellison syndrome. Two patients presented with abdominal pain, diarrhea, weight loss, and dysphagia while on acid suppressants. fasting hypergastrinemia was confirmed. endoscopy revealed peptic stricture of the esophagus with ulcerations in the stomach, duodenum, and jejunum. Imaging showed a mass in the head of pancreas. The first patient underwent distal esophagectomy, total gastrectomy, and resection of the head of pancreas for a pancreatic primary. Resection of the third and fourth parts of the duodenum and proximal jejunum was undertaken in the second patient with a duodenal primary. Malignant gastrinoma was confirmed histologically. "Supergastrinoma" describes a tumor causing synchronous peptic ulceration and/or stricture extending from the esophagus to the jejunum. Operative management entails customized resection of the areas irretrievably damaged by the ulceration together with the tumor.
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ranking = 7
keywords = esophagus
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