Oesophageal injury

Caustic injury secondary to impaction of ingested batteries is a potentially severe cause of oesophageal injury with an increasing incidence that reflects consumer trends and the utilisation of compact electronic devices. Delays to recognition and management are associated with increased risk of complications, morbidity and mortality. In this manuscript, we describe a case presentation and literature review of a patient presenting with upper oesophageal odynophagia after the deliberate ingestion of multiple foreign bodies.

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Missed oesophageal injury in gunshot wounds: A case presentation

Australian Emergency Nursing Journal ◽

10.1016/s1328-2743(02)80006-2 ◽

2002 ◽

Vol 5 (3) ◽

pp. 28-34

Author(s):

Jacinta Stewart ◽

Kate Curtis

Keyword(s):

Gunshot Wounds ◽

Case Presentation ◽

Oesophageal Injury

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Clinical and Endoscopic Characteristics of Medication Induced Esophageal Injury

Faridpur Medical College Journal ◽

10.3329/fmcj.v14i1.46157 ◽

2020 ◽

Vol 14 (1) ◽

pp. 2-7

Author(s):

Mohammad Quamrul Hasan ◽

Nelson Taposh Mondal ◽

Irin Perveen ◽

MM Shahin Ul Islam ◽

Md Khalequzzaman Sarker

Keyword(s):

Mucosal Healing ◽

Esophageal Injury ◽

Recumbent Position ◽

Alendronate Sodium ◽

Medical College ◽

Oesophageal Ulcer ◽

Causative Agents ◽

Oesophageal Injury ◽

Inflammatory Drugs ◽

Endoscopic Characteristics

Medications can cause several complications in the esophagus and lead to medication-induced esophageal injury. This study was carried out among patients diagnosed as medication-induced esophageal injury from June 2015 to October, 2018 in the Department of Gastroenterology, Enam Medical College and Hospital, Savar, Dhaka to investigate clinical and endoscopic characteristics of medication-induced esophageal injury as well as outcome of these patients with treatment. Patients diagnosed as malignancy, viral or fungal esophagitis, esophageal varix, corrosive and sclerotherapy induced ulcer and GERD were excluded. Clinical and endoscopic characteristics of patients diagnosed as medication-induced injury were analyzed. After given treatment, clinical improvements as well as mucosal healing of oesophageal injury were noted. Thirty seven patients were diagnosed as medication-induced esophageal injury. Their median age was 40; 17 were males and 20 were females. Common symptoms were chest pain (94.6 %), odynophagia (78.4 %) and dysphagia (62.2 %). Symptoms appeared between 3 hours to 15 hours after ingestion of medication. Predisposing factors for 75.67% of the patients were related to taking the medicine with insufficient water or in recumbent position, or both. The main causative agents were antibiotics, Non-steroidal anti-inflammatory drugs (NSAIDs) and Alendronate sodium. Common diseases that required treatment with these drugs were various urinary system diseases, osteoporosis and migraine. During endoscopy, 25 had only ulcer, 7 had only erosion and 5 had both ulcer and erosion. Most of the ulcers and erosions were located at the middle third of the oesophagus with a rate of 70%, and 58.3% respectively. Appearance of the ulcer was oval, circular, kissing and geographical shaped and their sizes vary between 6 mm to 18 mm and single or multiple in numbers. All the patients were treated with proton pump inhibitors (PPIs) or sucralfate, and the causative drugs were discontinued. Symptoms resolution occurred within 5 to 12 days after treatment and mucosal healing were detected in all patients after 4 weeks who were performed endoscopy. Almost every kind of medication, particularly doxycycline, NSAIDs can cause oesophageal ulcer and erosion. It can be successfully treated with PPIs and discontinuation of the causative medication and prevented by warning patients about drinking water sufficiently and sitting up while taking the pill. Faridpur Med. Coll. J. Jan 2019;14(1): 2-7

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Avoiding oesophageal injury during cardiac ablation: insights gained from mediastinal anatomy

EP Europace ◽

10.1093/europace/eux024 ◽

2017 ◽

Vol 20 (3) ◽

pp. 466-471 ◽

Cited By ~ 4

Author(s):

Devan Marar ◽

Venkatraman Muthusamy ◽

Subramaniam C Krishnan

Keyword(s):

Cardiac Ablation ◽

Oesophageal Injury

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Correlation of magnetic resonance imaging and post-ablation endoscopy to detect oesophageal thermal injury in patients after atrial fibrillation ablation: MRI-EDEL-study

EP Europace ◽

10.1093/europace/euaa081 ◽

2020 ◽

Vol 22 (7) ◽

pp. 1009-1016

Author(s):

Philipp Halbfass ◽

Lukas Lehmkuhl ◽

Borek Foldyna ◽

Artur Berkovitz ◽

Kai Sonne ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Atrial Fibrillation ◽

Magnetic Resonance ◽

Predictive Value ◽

Diagnostic Value ◽

Resonance Imaging ◽

Oesophageal Injury ◽

Mri Sequences ◽

Sensitivity Specificity ◽

Signal Intensities

Abstract Aims To correlate oesophageal magnetic resonance imaging (MRI) abnormalities with ablation-induced oesophageal injury detected in endoscopy. Methods and results Ablation-naïve patients with atrial fibrillation (AF), who underwent ablation using a contact force sensing irrigated radiofrequency ablation catheter, received a cardiac MRI on the day of ablation, and post-ablation oesophageal endoscopy (OE) 1 day after ablation. Two MRI expert readers recorded presence of abnormal oesophageal tissue signal intensities, defined as increased oesophageal signal in T2-fat-saturated (T2fs), short-tau inversion-recovery (STIR), or late gadolinium enhancement (LGE) sequences. Oesophageal endoscopy was performed by experienced operators. Finally, we correlated the presence of any affection with endoscopically detected oesophageal thermal lesions (EDEL). Among 50 consecutive patients (age 67 ± 7 years, 60% male), who received post-ablation MRI and OE, complete MRI data were available in 44 of 50 (88%) patients. In OE, 7 of 50 (14%) presented with EDEL (Category 1 lesion: erosion n = 3, Category 2 lesion: ulcer n = 4). Among those with EDEL, 6 of 7 (86%) patients presented with increased signal intensities in all three MRI sequences, while only 2 of 37 (5%) showed hyperintensities in all three MRI sequences and negative endoscopy. Correspondingly, sensitivity, specificity, positive predictive value, and negative predictive value (NPV) for MRI (increased signal in T2fs, STIR, and LGE) were 86%, 95%, 75%, and 97%, respectively. Conclusion Increased signal intensity in T2fs, STIR, and LGE represents independent markers of EDEL. In particular, the combination of all three has the highest diagnostic value. Hence, MRI may represent an accurate, non-invasive method to exclude acute oesophageal injury after AF ablation (NPV: 97%).

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