Cases reported "Esophageal Stenosis"

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1/171. Congenital esophageal stenosis.

    We report 6 new cases of congenital esophageal stenosis (CES) that presented to us with special diagnostic and management problems and review the literature on this subject. gastroesophageal reflux and achalasia are important differential diagnoses of esophageal stenosis, they may be associated with CES making appropriate management even more difficult. Treatment is also controversial, ranging from simple dilatation to segmental resection. CES should be present in every pediatric surgeon's mind should dysphagia occur on the introduction of semisolid food or esophageal food impaction, with a segmental stenosis demonstrated at esophagogram even when more obvious diagnoses are evoked.
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ranking = 1
keywords = dysphagia
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2/171. Dysphagia in oesophageal intramural pseudo-diverticulosis: fibrosis, dysmotility or web?

    We describe two cases of oesophageal intramural pseudo-diverticulosis associated with a cervical oesophageal web presenting as intermittent dysphagia. In both cases, disruption of the web endoscopically resulted in lasting relief from symptoms. This observation, together with a review of the literature written during the past 39 years, suggests that oesophageal web formation may be under-reported in this condition and may be more important than either dysmotility or submucosal fibrosis and stricturing in the aetiology of the dysphagia seen in these patients. All patients with a radiological diagnosis of oesophageal intramural pseudo-diverticulosis should have an endoscopic examination which may be both diagnostic and potentially therapeutic.
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ranking = 2
keywords = dysphagia
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3/171. Cricopharyngeal achalasia--a cause of major dysphagia in a newborn. A case report.

    Cricopharyngeal achalasia is a rare cause of neonatal dysphagia. Its treatment is based on surgical myotomy, which is to be avoided in the presence of prematurity and neurological diseases. The authors report a case of cricopharyngeal achalasia in a full-term four-month-old female baby. Coughing and choking during feeds were the major symptoms. The diagnosis was made peroperatively although barium meal and endoscopic findings were suggestive. After cricopharyngeal myotomy, symptoms took several weeks to disappear. Seven months after surgery, she feeds normally and weighs 7,700 g. Neonatal cricopharyngeal achalasia could be a foregoing state to cricopharyngeal diverticula in adult. Some cases may remain undiagnosed either due to lack of symptoms or sudden infant death.
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ranking = 5
keywords = dysphagia
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4/171. Ectopic gastric mucosa causing dysphagia due to strictures in a boy.

    Ectopic gastric mucosa in the upper esophagus has been reported previously in neonatal autopsy series and encountered in adult esophagoscopies. Despite the usual asymptomatic course of the disease, symptomatic adults have been reported. However there is no report of a symptomatic child with ectopic gastric mucosa in the literature. A 12-year-old boy presenting with dysphagia due to strictures resulting from circular patches of ectopic gastric mucosa located in the mid esophagus is reported.
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ranking = 5
keywords = dysphagia
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5/171. Symptom priority ranking in the care of gastroesophageal reflux: a review of 1,850 cases.

    BACKGROUND: Clinical history remains an important part of the medical evaluation of patients with gastroesophageal reflux disease (GERD). heartburn, regurgitation, and dysphagia are considered typical symptoms of GERD. Priority rankings of these symptoms can be determined with a standardized questionnaire. OBJECTIVE: To determine whether symptom priority ranking and symptom severity grading can provide useful information in the evaluation of patients with GERD. methods: From 1,850 patients that were analyzed retrospectively, patients with dysphagia unrelated to GERD were excluded. A standardized questionnaire was applied before each patient underwent any esophageal diagnostic study. Priority of symptoms was determined to be primary, secondary, tertiary, or none based on the patient response to the questionnaire. Presence of a stricture was determined either by endoscopy, esophagraphy, or both studies. Stationary esophageal manometry and 24-hour pH monitoring were performed on all patients. Through bivariate and multivariate analysis, the relationships among typical GERD symptoms, esophageal reflux-related stenosis, lower esophageal sphincter pressure, and composite score were established. RESULTS: High priority ranking of the symptom dysphagia is predictive of the presence of an esophageal stricture, but has a negative association with abnormal manometric and pH studies. In contrast, high priority ranking of the symptom heartburn and regurgitation are positively associated with abnormal manometric and pH results. CONCLUSIONS: Priority ranking can be a valuable adjunct to objective testing in the evaluation of GERD. In certain clinical situations it can obviate the need for 24-hour pH monitoring.
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ranking = 3
keywords = dysphagia
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6/171. Congenital esophageal stenosis treated with endoscopic balloon dilation: report of one case.

    Congenital esophageal stenosis is a narrowing of esophageal lumen that is present at birth, and may be asymptomatic in the neonate. Stenosis of the lower esophagus is a very rare form of esophageal obstruction. Three types of congenital esophageal stenosis have been described: fibromuscular stenosis, membranous webs, and tracheobronchial remnants. Fibromuscular stenosis and membranous webs respond to dilation, but must be distinguished from strictures caused by peptic esophagitis. Tracheobronchial remnants generally require surgical therapy. We report a 5-year-old girl with congenital esophageal stenosis, who presented with persistent dysphagia and poor weight gain. An esophagogram showed stricture of lower esophagus with proximal dilatation above esophagogastric junction. She was successfully treated with endoscopic balloon dilation.
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ranking = 1
keywords = dysphagia
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7/171. Use of esophagectomy to treat recurrent hyperplastic tissue obstruction caused by multiple metallic stent insertion for corrosive stricture.

    We report a case of a 75-year-old woman who received repeated metallic stent insertion for corrosive esophageal injury. She underwent esophagectomy and gastric tube reconstruction about 3 years after injury because both stents were occluded in turn by overgrowth of granulation tissue. The gross and microscopic changes of the esophagus secondary to prolonged stent insertion are described. In the literature, no reports of similar cases have been recorded. Our limited experience revealed that using metallic stents to treat benign esophageal stricture should be handled very cautiously because of the complications which can commonly occur and are difficult to manage. Repeated stent insertion, although effective for temporarily relieving dysphagia, is ineffective in the long run and can create complications. We suggest that the feasibility of esophagectomy should be evaluated after the improvement of the general condition of the patient.
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ranking = 1
keywords = dysphagia
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8/171. Severe complications caused by dissolution of latex with consequent self-disintegration of esophageal plastic tubes.

    A case of decisive material degeneration of an esophageal Celestin tube is described: a 50-year-old man with adenocarcinoma of the distal esophagus received a Celestin tube for palliative endoscopic treatment and 8 months later presented with suddenly occurring complete dysphagia. Dissolution of the latex layer in the proximal as well as the distal part of the tube had caused self-disintegration of the Celestin tube and had liberated the monofilament nylon coil which completely obstructed the lumen of the tube. Endoscopic tube removal was only possible by careful attachment of a balloon catheter and peroral extraction after insufflation with contrast medium up to 5 atm. A medline-based review of the literature revealed different but predominantly severe complications (perforation, hemorrhage, obstruction, and peritonitis) based on material fatigue of the latex layer in esophageal Celestin tubes. At least 6 months after placement of a Celestin tube, regular fluoroscopic controls should be performed to detect early disintegration of the tube. Indication for the placement of Celestin tubes in patients with benign esophageal strictures and longer life expectancy should be assessed very critically.
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ranking = 1
keywords = dysphagia
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9/171. Esophageal intramural pseudodiverticulosis associated with esophageal perforation.

    We report a rare case of esophageal intramural pseudodiverticulosis with lower esophageal stricture which perforated into the peritoneal cavity after the patient vomited. A 61-year-old man was admitted with severe chest and epigastric pain after dysphagia and vomiting. Under a diagnosis of upper gastrointestinal perforation, laparotomy was performed. The anterior wall of the abdominal esophagus was found to have ruptured, and proximal gastrectomy with abdominal esophagectomy was performed. Histological examination revealed esophageal intramural pseudodiverticulosis with esophageal stricture distal to the site of rupture, and postoperative endoscopy showed diffuse pseudodiverticulosis in the remaining esophagus. The patient is free of symptoms 5 years after the surgery. This case suggests that careful treatment may be indicated in patients with esophageal intramural pseudodiverticulosis with stricture and elevated intraluminal pressure, to minimize the possibility of severe complications such as esophageal perforation.
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ranking = 1
keywords = dysphagia
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10/171. Post-cricoid web associated with rubinstein-taybi syndrome.

    A case of dysphagia due to a post-cricoid web in a seven-year-old boy with rubinstein-taybi syndrome is presented. The main features of this syndrome are summarized with particular reference to dysphagia and with previous cases of post-cricoid webs in children reviewed.
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ranking = 2
keywords = dysphagia
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