Cases reported "Esophageal Diseases"

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1/102. Esophageal ulcer and alendronate.

    OBJECTIVE: To describe a case of esophageal ulcer associated with the use of alendronate. CASE REPORT: This is the fifth case ever described in the literature according to our bibliographic review. In our patient, the association between the drug and the esophageal lesions was masked by the presence of a hiatal hernia, potentially a cause of the esophageal lesion. The persistence of the lesions despite high doses of anti-reflux therapy called attention to the possibility of the relationship. The esophageal lesion healed soon after suspension of alendronate. DISCUSSION: The authors present a review of the literature and point to the need for diagnostic investigation, to suspend such a drug from patients who experience dyspeptic symptoms while using it.
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ranking = 1
keywords = reflux
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2/102. Management of postfundoplication complications.

    The role of surgical therapy in the management of gastroesophageal reflux disease (GERD) continues to evolve in the laparoscopic era. As the number of surgical procedures increases, so does the number of patients with postfundoplication complications. The most effective strategy is to prevent the complication in the first place. patients who are most likely to have trouble after surgery are those with refractory, atypical, or complicated disease. Gastroenterologists should take care to make an accurate diagnosis, heal the esophagitis, and dilate any strictures before sending a patient to surgery. The surgeon should be a skilled laparoscopist. In patients with complicated GERD, the surgeon must be able to recognize severe disease and perform advanced procedures. Postoperatively, symptoms are usually the same (suggesting a failure of the operation or incorrect original diagnosis) or different (suggesting a complication) than before surgery. Most patients should have a barium swallow and an endoscopy to evaluate the integrity of the wrap. If intact, postoperative heartburn and dysphagia will usually resolve with conservative therapy. If the fundoplication is poorly oriented, too long, too tight, twisted, or herniated above the diaphragm, surgical revision is often necessary.
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ranking = 87.472012029098
keywords = esophagitis, reflux
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3/102. Neuromotor disorders of the esophagus.

    Esophageal motility studies are helpful in diagnosing hypertensive and hypotensive disorders of the esophagus and its sphincters, including the exact measurement of the strength of contraction, temporal sequence and duration of the pathophysiology involved. In addition, the assessment of the extent of neuromotor involvement may be of great help to the surgeon in planning a myotomy. PH metering is probably the most accurate way to assess reflux in hypotonic states.
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ranking = 1
keywords = reflux
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4/102. Gastroesophageal involvement in herpes simplex.

    herpes simplex in the gastric mucosa has not been previously described. The case presented here describes gastritis and esophagitis resulting from herpes simplex in a patient being treated with immunosuppressive agents. These changes were confirmed endoscopically and radiographically. biopsy specimens of the gastric and esophageal mucosa showed eosinophilic intranuclear inclusion bodies typical of herpes simplex. The pathogenesis and pathological appearance of herpetic gastritis and esophagitis are presented.
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ranking = 172.9440240582
keywords = esophagitis
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5/102. Crohn's disease of the esophagus: report of a case.

    We report herein the case of a 27-year-old man with Crohn's disease of the esophagus. The patient presented with large ulcers in the esophagus for which treatment based on a diagnosis of reflux esophagitis was commenced. Although his symptoms were initially resolved, the ulcers did not improve and he was readmitted to hospital 3 months later for progressive heartburn. An esophagoscopy revealed large ulcers in the esophagus, and a colonoscopy revealed a longitudinal ulcer in the terminal ileum. Histological examination of specimens from the terminal ileum showed severe inflammation without granuloma formation, which led to a diagnosis of Crohn's disease. The oral administration of prednisolone and salazosulfapyridine controlled his symptoms and the esophageal ulcers were observed to be healing 2 weeks after this treatment was initiated. A review of the English literature revealed only 77 cases of this disease. Isolated esophageal lesions were reported in ten patients (13.0%), none of which were able to be diagnosed as Crohn's disease preoperatively. Ileocolic lesions developed after esophageal lesions in only five patients (6.5%) including ours. In the remaining 62 patients (80.5%), ileocolic lesions had existed synchronous with or prior to the esophageal lesions. This suggests that ileocolic lesions may often coexist in Crohn's patients with esophageal lesions, and that examination of the terminal ileum must be performed to confirm a diagnosis of Crohn's disease of the esophagus.
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ranking = 87.472012029098
keywords = esophagitis, reflux
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6/102. Case of ulcerative colitis associated with oesophageal ulcer.

    A case of ulcerative colitis complicated by oesophageal ulcers is reported. A woman was admitted to our hospital because of exacerbations of ulcerative colitis both in 1992 (aged 15 years) and 1995 (aged 18 years). When she was admitted in 1995 she complained of bloody diarrhoea, sore throat and pain on swallowing. Oesophagogastro-duodenoscopy revealed oesophageal ulcers. Oesophageal pH monitoring (24-h) showed no evidence of gastro-oesophageal reflux disease. After the patient was treated she with oral prednisolone showed considerable improvement clinically and endoscopically. Initial dosage was 60 mg/day, and 1 week later, the dosage was gradually dropped since the patient responded favourably. The improvement of the oesophageal lesions coincided with the remission of ulcerative colitis. The oesophageal ulcers are, therefore, thought to be an extracolonic manifestation of ulcerative colitis.
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ranking = 1
keywords = reflux
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7/102. Oesophageal surgery.

    A wide variety of benign conditions affecting the oesophagus which have long been recognized in association with hiatus hernia are now known to be attributable to reflux oesophagitis. The development of modern methods of treatment of these conditions is described with reference to a number of illustrative cases.
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ranking = 87.472012029098
keywords = esophagitis, reflux
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8/102. Esophagobronchial fistula combined with a peptic esophageal stenosis.

    Peptic strictures are a rare complication of severe gastroesophageal reflux disease. An esophagobronchial fistula as a complication of a severe long-term reflux esophagitis with peptic stenosis is here described for the first time: A 43-year-old mentally disabled patient suffered from recurrent bronchopneumonia. endoscopy revealed an esophagobronchial fistula originating in a peptic stricture. Under short-term fasting, intravenous feeding and application of a proton pump inhibitor (PPI) closure of this fistula was achieved within 4 days. Subsequently, dilatation was carried out. The case demonstrates that pulmonary complications in patients with peptic esophageal strictures may not only be due to aspiration of refluxate but--rarely--also to fistulae between the esophagus and the bronchial tree.
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ranking = 89.472012029098
keywords = esophagitis, reflux
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9/102. Esophageal lichen planus: case report and review of the literature.

    Involvement of the esophagus by lichen planus is a rarely reported condition. The histologic features of esophageal lichen planus, which may differ from those of cutaneous disease, have only rarely been illustrated. We describe a 58-year-old woman with skin and oral lichen planus who presented with dysphagia and an esophageal stricture that were ultimately diagnosed as esophageal lichen planus. Multiple esophageal biopsies demonstrated a lichenoid, T cell-rich lymphocytic infiltrate, along with degeneration of the basal epithelium and Civatte bodies. Correct diagnosis of esophageal lichen planus is critical because of its prognostic and therapeutic distinction from other more common causes of esophagitis and stricture formation.
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ranking = 86.472012029098
keywords = esophagitis
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10/102. Esophageal inflammatory pseudotumor mimicking malignancy.

    A 54-year-old man with a complaint of dysphagia was found to have a prominent stricture in the proximal esophagus. A biopsy of the stenotic area indicated sarcoma, leading to subtotal esophagectomy. The surgically removed esophagus demonstrated a well-defined intramural mass, consisting of a mixture of fibroblastic cells with bland cytological appearances and inflammatory cells. Reflux esophagitis which was present distal to the stricture seemed to play a role in the development of this inflammatory pseudotumor.
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ranking = 86.472012029098
keywords = esophagitis
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