scholarly journals Multiple Gastric Erosion Early after a 3 V Lithium Battery (CR2025) Ingestion in an 18-Month-Old Male Patient: Consideration about the Proper Time of Intervention

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Ioannis Patoulias ◽  
Christos Kaselas ◽  
Dimitrios Patoulias ◽  
Konstantinos Farmakis ◽  
Eleni Papacrivou ◽  
...  
Keyword(s):  
Male Patient ◽  
Proper Time ◽  
Emergency Situation ◽  
Gastric Erosion ◽  
Button Battery ◽  
Negative Pole ◽  
Asymptomatic Patients ◽  
Lethal Complications ◽  
Mucosal Erosion ◽  
Time Of Intervention

Introduction. Button battery ingestion is considered an emergency situation in pediatric patients that needs to be managed promptly; otherwise, it may lead to serious and potentially lethal complications, especially when it is impacted in the esophagus. Less attention has been given in cases where the battery passes into the stomach, with guidelines for emergency intervention being based on the presence of symptoms. Case Report. We present a case of an 18-month-old male patient who presented to our emergency department after button battery ingestion. He did not have any symptoms and no pathological findings were encountered during clinical examination. X-ray investigation revealed the presence of the battery in the stomach. The patient was admitted for observation and two hours later he had two episodes of vomiting. He underwent urgent endoscopic removal of the battery where multiple acute gastric mucosal erosion in place of direct contact of the battery’s negative pole with the mucosa of the gastric antrum was found. Conclusion. In specific cases the urgent endoscopic intervention for removal of an ingested button battery that is located in the stomach even in asymptomatic patients should be suggested.

scholarly journals Pattern of Childhood Glaucoma

1970 ◽  
Vol 39 (133) ◽  
pp. 150-153
Author(s):  
S Shakya ◽  
S Koirala ◽  
E Pradhan
Keyword(s):  
Intraocular Pressure ◽  
Retrospective Study ◽  
Visual Loss ◽  
Proper Time ◽  
Disease Process ◽  
Nerve Fibers ◽  
Congenital Glaucoma ◽  
Western World ◽  
Presentation Time ◽  
Time Of Intervention

Glaucoma is one of the important causes of blindness in children all over the world1 .Childhood glaucoma encompasses a wide variety of conditions ranging from primarycongenital glaucoma to different acquired varieties. They may present with only ocularinvolvement or as a part of a syndrome with multiple system involvement. Thevisual prognosis of childhood glaucoma depends upon the structural involvement, stageof presentation, time of intervention and their follow up2. Though all glaucomas areknown to produce blindness, childhood glaucoma unlike the glaucoma in adults havedifferent disease process which enables the optic nerve fibers to regain their functionalintegrity once the IOP is brought down to normal.3 Thus, early diagnosis andearly treatment to achieve normal intraocular pressure can, to some extent, bringback one’s vision. Childhood glaucoma certainly needs to be addressed with muchmore emphasis than that of adult glaucoma, as it may threaten physical as well asmental growth if not tackled at proper time to retain visual stimuli.Most of the literatures on childhood glaucoma have emerged from western world 4,5,6.There has been no literature in this regard from Nepal and profile of childhood glaucomais yet to be determined. This was a retrospective study carried out by GlaucomaUnit B.P. Koirala Lions Center of Ophthalmic Studies with the main intention to seethe profile of glaucoma in Nepalese children.Out of a total of 475 cases of glaucoma seen in a period of 5 years, 27 (5.68%) werefound to be the cases of congenital glaucomas.Primary congenital glaucoma (PCG) was most frequently seen among children. Majorityof the cases of PCG presented late, after 3 years of age, with significant amountof visual loss. Most of them were brought to hospital for the complaint of watering andenlargement of eyeball.

scholarly journals Increased risk of aspirin-induced gastric mucosal erosion in elderly Chinese men harboring SLCO1B1*1b/*1b while using aspirin and an ACEI or ARB concomitantly

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Lei Duan ◽  
Yongyi Bai ◽  
Man Li ◽  
Huiying Li ◽  
Yanping Li ◽  
...  
Keyword(s):  
Chinese Patients ◽  
Taqman Assay ◽  
Control Group ◽  
Gastric Erosion ◽  
Elderly Male ◽  
Endoscopic Screening ◽  
Chinese Men ◽  
Increased Risk ◽  
Elderly Chinese ◽  
Mucosal Erosion

Abstract Background It is well established that long-term use of aspirin can cause gastric mucosal injury. ACEIs and ARBs are inversely related to gastric ulcer development. This study aimed to evaluate the relationship between SLCO1B1 polymorphisms, which can affect ACEI and ARB transport, and gastric mucosal erosion in elderly male Chinese patients with cardiovascular disease who use aspirin. Methods Patients taking aspirin and an ACEI or ARB concomitantly who had undergone endoscopic screening for gastric erosion were analyzed for SLCO1B1 polymorphisms by a TaqMan assay. Results The frequency of the SLCO1B1*1b/*1b diplotype (42% vs. 24%; p = 0.002) was significantly higher in the gastric mucosal erosion group than in the control group. After adjustment for significant factors, SLCO1B1*1b/*1b (OR, 2.64; 95% CI, 1.59–4.17; p < 0.05) was found to be associated with gastric mucosal erosion in aspirin users. Conclusions The presence of the SLCO1B1*1b/*1b diplotype may be a risk factor for aspirin-induced gastric mucosal erosion in elderly Chinese men taking aspirin and an ACEI or ARB concomitantly.

Outcomes of Children Presenting with Button Battery in Esophagus: A Retrospective Review

2020 ◽  
Vol 42 (1) ◽  
pp. 44-48
Author(s):  
Bigyan R Gyawali ◽  
Rajendra P Sharma Guragain ◽  
Yogesh Neupane ◽  
Heempali Dutta ◽  
Lava Shrestha ◽  
...  
Keyword(s):  
Mucosal Injury ◽  
Paediatric Population ◽  
University Teaching ◽  
Time Interval ◽  
Button Battery ◽  
Patient Demographics ◽  
Final Sample ◽  
Superficial Ulcer ◽  
Mucosal Erosion ◽  
Abductor Palsy

Introduction Foreign body in esophagus is a common ENT emergency. Button batteries tend to have more grievous outcomes due to caustic mucosal injury to the esophagus. The objective of our study was to review the clinical profile and outcomes of the paediatric population in our center who presented with button battery in esophagus following accidental ingestion. MethodsThis was a retrospective study conducted in Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Hospital records of all the patients who presented with button battery esophagus and underwent rigid oesophagoscopic removal from January 2013 to January 2019 were reviewed and analyzed for patient demographics, time interval between ingestion and presentation, site of impaction, status of oesophageal mucosa at the time of rigid oesophagoscopic removal of the battery, early post-operative complications, outcomes at the time of discharge and on follow-up. ResultsOur final sample size was 11 and all cases were <15 years. The average duration from time of ingestion to presentation to our hospital ranged from 1 day to 2 months. Variable oesophageal mucosal findings such as superficial mucosal erosion, superficial ulcer with slough and granulations with deep discrete ulcer were seen at the site of impaction of the button battery. One case was diagnosed with bilateral abductor palsy on 10th post-operative day following rigid oesophagoscopic removal of the battery. All other cases didn’t develop any significant complications. ConclusionButton battery in esophagus results in oesophageal ulceration and thus warrants an early endoscopic removal. Delayed removal can also cause bilateral abductor palsy from the caustic damage to recurrent laryngeal nerve.

scholarly journals Gastric metastasis from pancreatic cancer characterized by mucosal erosion: a case report and literature review

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110037
Author(s):  
Jie Yang ◽  
Yue Yuan ◽  
Shu Zhang ◽  
Ying Lv
Keyword(s):  
Pancreatic Cancer ◽  
Needle Aspiration ◽  
Metastatic Lesion ◽  
Gastric Erosion ◽  
Invasive Adenocarcinoma ◽  
Gastric Metastasis ◽  
Pancreatic Biopsy ◽  
History Of ◽  
Head Of The Pancreas ◽  
Mucosal Erosion

Pancreatic cancer with gastrointestinal tract metastasis is a fairly rare occurrence, and gastric metastasis in such cases has been seldom reported. We herein present a case of gastric involvement secondary to pancreatic cancer in a 74-year-old woman in whom the metastatic lesion only presented as mucosal erosion in the stomach. The patient had a 1-month history of progressive right upper quadrant pain before admission. Computed tomography and endoscopic examinations revealed a solid and hypo-enhancing mass in the head of the pancreas. The patient underwent conventional upper endoscopy before pancreatic biopsy, and mucosal erosion was observed in the gastric pylorus. We obtained gastric and pancreatic biopsies by gastroscopy and endoscopic ultrasound-guided fine needle aspiration, respectively. Pathologically, the biopsies taken from the area of gastric erosion showed poorly differentiated invasive adenocarcinoma that was morphologically consistent with the pancreatic specimens. Moreover, the gastric section showed tumor thrombi within the vessels. Hence, the suspected diagnosis was unresectable pancreatic cancer with gastric metastasis. The patient immediately underwent two courses of chemotherapy, but her condition rapidly deteriorated and she died 2 months later.

scholarly journals Bilateral vocal cord paralysis caused by accidental button battery ingestion in children: A case report and literature review

2021 ◽  
pp. 014556132110436
Author(s):  
Brendan Kosko ◽  
Torin P. Thielhelm ◽  
Ranbir Ahluwalia ◽  
Marc Levy ◽  
James Kosko
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Case Reports ◽  
Fistula Formation ◽  
Bilateral Vocal Cord Paralysis ◽  
Button Battery ◽  
Long Term Follow Up ◽  
Multiple Case ◽  
Mucosal Erosion ◽  
Pediatric Populations

Button battery ingestion in pediatric populations is a common occurrence with severe sequelae. Multiple case reports have established the occurrence of death, fistula formation, mucosal erosion, esophageal perforation, and bleeding post-ingestion of button batteries. However, there is a gap in the literature on the occurrence of bilateral vocal cord paralysis post-lithium battery ingestion. We present a case in which a 12-month-old male developed bilateral vocal cord paralysis following ingestion of a button battery. We compare our case to eleven other reports that exist in the literature based on age, sex, time until removal, clinical presentation, day upon which vocal cord paralysis developed, anatomic location, and post-operative course. We conclude that bilateral vocal cord paralysis is a time-sensitive complication which requires prompt diagnosis. Any child with stridor following button battery ingestion should undergo consultation with pediatric otolaryngology immediately. In addition, long-term follow-up is necessary to evaluate return of normal vocal cord function.

scholarly journals Endoscopic Evaluation for Stricture Formation Post Button Battery Ingestion

2021 ◽  
Vol 13 (3) ◽  
pp. 511-519
Author(s):  
Amber Bulna ◽  
Amanda C. Fifi
Keyword(s):  
Tube Placement ◽  
Esophageal Injury ◽  
Barium Swallow ◽  
Stricture Formation ◽  
Button Battery ◽  
Delay In Diagnosis ◽  
Repeat Endoscopy ◽  
Asymptomatic Patients ◽  
Increased Risk ◽  
Nasogastric Tube Placement

Every year, there are over 3300 ingestions of button batteries, mostly by young children. Initial presentation of button battery ingestion may be nonspecific, with a delay in diagnosis and removal resulting in increased risk of complications. We present the case of a five-year-old female who presented with vomiting following unwitnessed button battery ingestion. The battery was impacted in the middle esophagus for at least six hours. Endoscopy was performed for immediate removal and showed a Grade 2B erosion, warranting nasogastric tube placement. The patient remained asymptomatic following discharge and had a barium swallow that was read as normal. However, a repeat endoscopy one month later visualized stricture formation at the previous battery injury site. This case highlights the importance of both clinician and parent awareness of button battery ingestion and demonstrates that endoscopy provides the most accurate assessment of esophageal injury and complication development, even in asymptomatic patients.

Remission of Recurrent Cochlear Hydrops Associated With Bromocriptine Treatment for Macroprolactinoma

2019 ◽  
Vol 28 (3) ◽  
pp. 548-552
Author(s):  
Andro Košec ◽  
Ivan Kruljac ◽  
Jakov Ajduk
Keyword(s):  
Dopamine Receptors ◽  
Male Patient ◽  
Endolymphatic Hydrops ◽  
Young Male ◽  
Oral Steroid ◽  
Case Description ◽  
Diuretic Treatment ◽  
Potential Therapeutic Role ◽  
Transient Improvement ◽  
Systemic Glucocorticoids

Objective Current recommendations for cochlear hydrops treatment include systemic glucocorticoids and diuretics. Cochlear cells express dopamine receptors, although their role is unknown in the pathophysiology of cochlear hydrops. Case Description We report the case of remission of recurrent right-sided cochlear hydrops in a young male patient treated with bromocriptine due to pituitary macroprolactinoma. Transient improvement was observed after oral steroid and diuretic treatment, but cochlear hydrops recurred until the dose of bromocriptine was increased to 10 mg daily. Conclusion Bromocriptine may stimulate dopamine receptors in cochlear cells with potential therapeutic role in patients with cochlear hydrops. There are no widely accepted and effective treatments for endolymphatic hydrops, and identifying potential new and efficacious therapeutics is of high relevance.

Clinical Update: Assessing Maximum Medical Improvement in Carpal Tunnel Syndrome

2003 ◽  
Vol 8 (4) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Proper Time ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Factors Affecting ◽  
Early Results ◽  
Medical Evaluation ◽  
Nerve Recovery ◽  
Tunnel Syndrome

Abstract Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) states: “Factors affecting nerve recovery in compression lesions include nerve fiber pathology, level of injury, duration of injury, and status of end organs,” but age is not prognostic. The AMA Guides clarifies: “High axonotmesis lesions may take 1 to 2 years for maximum recovery, whereas even lesions at the wrist may take 6 to 9 months for maximal recovery of nerve function.” The authors review 3 studies that followed patients’ long-term recovery of hand function after open carpal tunnel release surgery and found that estimates of MMI ranged from 25 weeks to 24 months (for “significant improvement”) to 18 to 24 months. The authors suggest that if the early results of surgery suggest a patient's improvement in the activities of daily living (ADL) and an examination shows few or no symptoms, the result can be assessed early. If major symptoms and ADL problems persist, the examiner should wait at least 6 to 12 months, until symptoms appear to stop improving. A patient with carpal tunnel syndrome who declines a release can be rated for impairment, and, as appropriate, the physician may wish to make a written note of this in the medical evaluation report.

Case Example: Adjacent Segment Disease: What Is It, and How Is It Rated?

2011 ◽  
Vol 16 (2) ◽  
pp. 8-9
Author(s):  
Marjorie Eskay-Auerbach
Keyword(s):  
Clinical Symptoms ◽  
Lumbar Fusion ◽  
Adjacent Segment Degeneration ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Disc Space Narrowing ◽  
Disc Disease ◽  
Disc Space ◽  
Radiographic Findings ◽  
Asymptomatic Patients

Abstract The incidence of cervical and lumbar fusion surgery has increased in the past twenty years, and during follow-up some of these patients develop changes at the adjacent segment. Recognizing that adjacent segment degeneration and disease may occur in the future does not alter the rating for a cervical or lumbar fusion at the time the patient's condition is determined to be at maximum medical improvement (MMI). The term adjacent segment degeneration refers to the presence of radiographic findings of degenerative disc disease, including disc space narrowing, instability, and so on at the motion segment above or below a cervical or lumbar fusion. Adjacent segment disease refers to the development of new clinical symptoms that correspond to these changes on imaging. The biomechanics of adjacent segment degeneration have been studied, and, although the exact mechanism is uncertain, genetics may play a role. Findings associated with adjacent segment degeneration include degeneration of the facet joints with hypertrophy and thickening of the ligamentum flavum, disc space collapse, and translation—but the clinical significance of these radiographic degenerative changes remains unclear, particularly in light of the known presence of abnormal findings in asymptomatic patients. Evaluators should not rate an individual in anticipation of the development of changes at the level above a fusion, although such a development is a recognized possibility.

Are asymptomatic patients likely to benefit from carotid interventions?

2006 ◽  
Vol 39 (2) ◽  
pp. 15
Author(s):  
Barry T. Katzen ◽  
Trevor Cleveland
Keyword(s):  
Asymptomatic Patients
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