Cases reported "Esophageal Stenosis"

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1/140. Gastrojejunal interposition for esophageal replacement.

    The main considerations in replacing the esophagus are to avoid postoperative necrosis of all or part of the graft, leakage or stenosis of the anastomoses, and complications related to acid-peptic or alkaline reflux. A 5-year-old boy, after two unsuccessful thoracic operations for atresia and then stenosis of the esophagus, underwent resection of the esophagus because of duodeno-gastroesophageal reflux. The continuity of the alimentary tract was restored by gastrojejunal interposition. We recommend this method of reconstruction when the esophago-gastrostoma is created in the chest, and the possibility of alkaline reflux must be considered.
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ranking = 1
keywords = stenosis
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2/140. 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 = 3.5
keywords = stenosis
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3/140. 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 = 0.5
keywords = stenosis
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4/140. Application of self-expanding metallic stents to malignant stricture following mechanically stapled esophagojejunostomy: report of two cases.

    Several types of self-expanding metallic stents (SEMS) were placed in two patients suffering from severe malignant stricture at the site of a mechanically stapled esophagojejunostomy used for the treatment of recurrent gastric cancer. Following modified Gianturco stent placement with limited success in one of the patients, an additional Ultraflex stent (boston Scientific Co., boston, USA) failed to expand satisfactorily at the outlet of the second stent. In the other patient, since the proximal end of an additional covered Ultraflex stent (boston Scientific Co.) inserted through the first one failed to expand satisfactorily at the level of severe stenosis because of the extreme rigidity caused by the mechanical staples, a spiral Z-stent was inserted to dilate it. The cases reported here raise some problems associated with the treatment of severely malignant stricture accompanied by extreme rigidity following mechanically stapled esophagojejunostomy with SEMS.
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ranking = 0.5
keywords = stenosis
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5/140. 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 = 4.5
keywords = stenosis
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6/140. Are self-expanding metal mesh stents useful in the treatment of benign esophageal stenoses and fistulas? An experience of four cases.

    OBJECTIVE: The aim of this study was to review the long-term results of treating benign esophageal fistula and stenosis using self-expanding metal stents. methods: We treated four patients using covered mesh or coiled stents. We removed the stents electively in two patients (one endoscopically and one during planned partial esophagectomy) and unexpectedly in one patient who developed bleeding. One stent migrated and required laparotomy for removal. RESULTS: Placement of self-expanding metal stents successfully sealed the benign fistula in two patients and reestablished swallowing in two other patients with complicated achalasia. Two patients were swallowing normally on long-term follow-up, one died of the underlying disease, and one required gastrostomy. CONCLUSION: Temporary use of self-expanding metal stents as a feasible option for treating benign esophageal stenosis and fistula in patients who have failed other conventional treatments.
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ranking = 1
keywords = stenosis
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7/140. Endoscopic retrieval of a broken and migrated esophageal metal stent.

    In patients with inoperable malignant tumors of the esophagus or cardia, self-expanding metal stents are increasingly used to improve dysphagia. Usually, they are not difficult to place and, as compared to conventional plastic stents, complications such as stent migration or perforation, seem to occur less frequently. This is a report on a young patient with metastatic adenocarcinoma of the cardia, who was treated with a self expanding metal stent after endoscopic dilatation of a tumor stenosis in the distal esophagus. Immediately after the procedure, he was able to eat and gained weight. Within 6 weeks and while on continuous infusion of 5-fluorouracil, the patient complained about recurrent severe dysphagia. Plain x-ray demonstrated a broken and migrated stent, the 2 parts of which were seen in the stomach and the duodenum. The stent could be extracted endoscopically without any complication, but the procedure was difficult and lasted 4 h, as the stent broke 2 more times during retrieval.
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ranking = 0.5
keywords = stenosis
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8/140. 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 = 2.5
keywords = stenosis
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9/140. Balloon dilation of an esophageal stenosis in a patient with recessive dystrophic epidermolysis bullosa.

    We report a 13-year-old boy with recessive dystrophic epidermolysis bullosa who had dysphagia due to esophageal stenosis. A balloon dilation was successfully performed under flexible endoscopic and fluoroscopic control. The early and long-term follow-up was characterized by the disappearance of dysphagia, weight gain, and improvement of his skin lesions.
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ranking = 2.5
keywords = stenosis
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10/140. Recurrent peptic stenosis of the esophagus: treatment with a self-expanding metallic stent.

    A 12-year-old neurologically impaired boy with recurrent peptic stenosis of the esophagus was treated successfully with use of a self-expanding metallic stent that remained for 3 months.
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ranking = 2.5
keywords = stenosis
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