scholarly journals Endoscopic Reconstruction of an Oral Feeding Route Using a Rendezvous Approach

2021 ◽  
pp. 1-6
Author(s):  
Sara Teles de Campos ◽  
Ricardo Rio-Tinto ◽  
Paulo Fidalgo ◽  
Miguel Bispo ◽  
Susana Marques ◽  
...  
Keyword(s):  
Balloon Dilation ◽  
Oral Feeding ◽  
Clinical Settings ◽  
Esophageal Obstruction ◽  
Case Presentation ◽  
Surgical Closure ◽  
Esophageal Lumen ◽  
Rendezvous Technique ◽  
Successful Case ◽  
Endoscopic Reconstruction

<b><i>Background:</i></b> The approach to esophageal obstruction or discontinuity remains challenging and often involves complex reconstructive surgeries. The rendezvous endoscopic technique might be interesting in cases of complete esophageal obstruction. <b><i>Case Presentation:</i></b> Herein we describe a successful case of endoscopic recanalization of the esophageal lumen in a patient with a long-standing esophageal discontinuity resulting from several surgeries and chemoradiation for a squamous cell carcinoma of the hypopharynx, ending in a major cervical amputation, construction of a neopharynx, and definitive surgical closure of the superior esophagus with a PEG placement. With a rendezvous technique (peroral and through the gastrostomy) and under radiographic guidance, puncture from the neopharynx into the distal esophagus was performed, followed by balloon dilation and covered metal stent placement in order to reconstruct a neoesophagus. Five weeks later, the stent was removed (using a stent-in-stent technique). No complications occurred. The patient has been able to eat soft food and is being kept under regular endoscopic surveillance to control/treat a luminal stenosis of the neoesophagus. <b><i>Conclusions:</i></b> This case report illustrates a successful endoscopic treatment of post-surgical complete esophageal obstruction. This approach should be considered in the therapeutic armamentarium of these difficult clinical settings.

scholarly journals Transient maintenance of tracheal patency upon the insertion of a flexible bronchoscope in a patient with an anterior mediastinal mass: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takayuki Hasegawa ◽  
Shinju Obara ◽  
Rieko Oishi ◽  
Satsuki Shirota ◽  
Jun Honda ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Mediastinal Mass ◽  
Balloon Dilation ◽  
Maximum Flow ◽  
Anterior Mediastinal Mass ◽  
Positive Pressure ◽  
Anesthesia Induction ◽  
Flexible Bronchoscope ◽  
Case Presentation ◽  
Tracheal Collapse

Abstract Background Patients with an anterior mediastinal mass are at risk of perioperative respiratory collapse. Case presentation A 74-year-old woman with a large anterior mediastinal mass that led to partial tracheal collapse (shortest diameter, 1.3 mm) was scheduled for tracheobronchial balloon dilation and stent placement under general anesthesia. Although veno-venous extracorporeal membrane oxygenation (V-V ECMO) had been established, maximum flow was limited to 1.6 L/min, and general anesthesia induction was followed by hypoxia probably due to inadequate ventilation. A flexible bronchoscope was inserted through the tracheal lumen that was being compressed by the anterior mass; this not only increased tracheal patency but also enabled positive pressure ventilation and resulted in recovery from hypoxia. Scheduled procedures were successfully performed without complications. Conclusion We describe a case wherein tracheal patency was transiently maintained by inserting a flexible bronchoscope in a patient with an anterior mediastinal mass.

scholarly journals Successful treatment of hepatic lymphorrhea by percutaneous transhepatic lymphangiography followed by sclerotherapy using OK-432

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Masayuki Kojima ◽  
Masanori Inoue ◽  
Seiichiro Yamamoto ◽  
Toshio Kanai ◽  
Seishi Nakatsuka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Intraperitoneal Administration ◽  
Lymphatic Vessels ◽  
Hepatoduodenal Ligament ◽  
Massive Ascites ◽  
Case Presentation ◽  
Successful Case ◽  
Leakage Site ◽  
And Control

Abstract Background Conventional lymphangiography cannot detect leakage sites of hepatic lymphatic vessels. Percutaneous transhepatic lymphangiography can be used to visualize leakage sites, and once the leakage site has been confirmed, effective sclerotherapy can be performed. Case presentation A rare case of intractable hepatic lymphorrhea due to injury of the hepatoduodenal ligament following pancreaticoduodenectomy is reported. Drainage of massive ascites from the drainage tube continued after surgery. Percutaneous transhepatic lymphangiography visualized the intrahepatic lymphatic vessels and the leakage site at the hepatic hilum. An 8-Fr drainage catheter was inserted adjacent to the leakage point under fluoroscopic computed tomography guidance. Repeated sclerotherapy using intraperitoneal administration of OK-432 (picibanil) through the catheter was performed, which exposed the leakage site, and control of the ascites was finally achieved. Conclusions To the best of our knowledge, this is the first successful case of detection of a leakage site using intrahepatic lymphangiography, followed by sclerotherapy using OK-432.

scholarly journals Modern approaches to the diagnostics and potentials of endoscopic treatment of esophageal stenoses in children

2021 ◽  
Vol 25 (4) ◽  
pp. 267-273
Author(s):  
A. O. Merkulova ◽  
A. Yu. Kharitonova ◽  
O. V. Karaseva ◽  
A. A. Shavrov
Keyword(s):  
Minimally Invasive ◽  
Clinical Picture ◽  
Scientific Literature ◽  
Balloon Dilation ◽  
Esophageal Stenosis ◽  
Cochrane Library ◽  
Common Disease ◽  
Esophageal Lumen ◽  
Literary Sources ◽  
Wide Range

Introduction. Esophageal stenosis in childhood is quite a common disease characterized by different etiology, specific clinical picture, wide range of differential diseases and a variety of approaches to its treatment.Material and methods. The review analyzes scientific literature presented in such search engines as Medline, PubMed, Cochrane Library, eLibrary, 20 years deep. The most significant works of the last century were included too. Keywords were used for search.Results. There were selected 60 literary sources which included the description of modern concepts of etiopathogenesis, classification, diagnostic and curative techniques for the treatment of esophageal stenosis in children. A particular attention is paid to the safety and effectiveness of minimally invasive endoscopic interventions (bougienage, balloon dilation) as well as to the topical application of Mitomycin C in the treatment of esophageal stenosis in children.Conclusion. Innovative endoscopic technologies applied for the restoration of the esophageal lumen seem to be promising, effective and safe. In the overwhelming majority of cases, they allow to reduce surgical aggression and avoid complex reconstructive surgeries.

scholarly journals Nasogastric Tube Feeding-Induced Esophageal Bezoar: Case Description

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Jad A. Degheili ◽  
Mikhael G. Sebaaly ◽  
Ali H. Hallal
Keyword(s):  
Enteral Feeding ◽  
Nasogastric Tube ◽  
Alimentary Tract ◽  
Tube Feeding ◽  
Esophageal Obstruction ◽  
Case Presentation ◽  
Postmyocardial Infarction ◽  
Multiple Risk Factors ◽  
Care Approach ◽  
Nasogastric Tube Feeding

Background. Bezoars are well established entities causing gastrointestinal obstructions. Depending on the prominent constituent of these bezoars, the latter are divided into four subtypes: pharmacobezoars, lactobezoars, trichobezoars, and phytobezoars. Less frequently reported types of bezoars are reported including those formed secondary to nasogastric tube feeding with casein-based formulas. Case Presentation. A 69-year-old male presented following cardiac arrest postmyocardial infarction. Patient sustained anoxic brain injury after resuscitation, rendering him ventilator dependant along with nasogastric tube feeding, initially. Dislodging of the nasogastric tube at one time rendered it difficult to reinsert it, with investigation showing the presence of calcified material within the distal oesophagus, mainly composed of casein-based products secondary to enteral feeding. Conclusion. Bezoars are well known to cause gastrointestinal obstructions due to their indigestible characteristics within the alimentary tract. More rare causes of bezoars include those formed from casein-based feeding formulas administered to patients with sustained enteral feeding. Esophageal obstruction, secondary to casein-based bezoars, occurs due to multiple risk factors, especially in those necessitating intensive care. Approach in such scenarios requires a multiteam approach.

Endoscopic management of radiation-induced complete upper esophageal obstruction with an antegrade-retrograde rendezvous technique

2006 ◽  
Vol 64 (5) ◽  
pp. 822-828 ◽  
Author(s):  
John T. Maple ◽  
Bret T. Petersen ◽  
Todd H. Baron ◽  
Jan L. Kasperbauer ◽  
Louis M. Wong Kee Song ◽  
...  
Keyword(s):  
Endoscopic Management ◽  
Esophageal Obstruction ◽  
Rendezvous Technique ◽  
Radiation Induced

scholarly journals Conservative Treatment of Huge Retroperitoneal Hematoma Postpartum: Case Report

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Sedigheh Ghasemian Dizajmehr ◽  
Farzaneh Rashidi Fakari ◽  
Mohsen Ghasemian
Keyword(s):  
Caesarean Section ◽  
Conservative Treatment ◽  
Retroperitoneal Hematoma ◽  
Proper Treatment ◽  
Cesarean Sections ◽  
Term Pregnancy ◽  
Case Presentation ◽  
Successful Case ◽  
Fluid Leak ◽  
Previous Cesarean

Introduction: Retroperitoneal hematoma are an important factor for hospitalization in patients with trauma and proper treatment is still under discussion and Controversial. We describe a successful case of conservative treatment of huge hematoma after cesarean section. Case presentation: An Iranian 34-year-old multigravida(G4L3) woman with three previous cesarean sections from Urmia province presented to our hospital with amniotic fluid leak. She had full-term pregnancy. Caesarean section was done. One day after caesarean section, she became dyspnea and had chest pain in left side. Embolism is suspected and enoxaparin was administered. According, hemoglobin decreased (HB:6.2) after administered the second dose of enoxaparin and a clear dullness percussion led tosuspected to hemorrhage and retroperitoneal hematoma was discontinued enoxaparin. After the patient is stable, the patient was discharged and retroperitoneal hematoma was followed up by ultrasonography and conservative treatment. Conclusion: Conservative treatment of retroperitoneal hematoma postpartum with good clinical evolution, depends on status of the patient, cause of injury and its evolution.

scholarly journals The significance of early rehabilitation of a severely polytraumatized child: Case report

2002 ◽  
Vol 55 (9-10) ◽  
pp. 427-430
Author(s):  
Milena Kovac ◽  
Dragoslav Serpak ◽  
Jovanka Vucinic ◽  
Daliborka Borovcanin ◽  
Tatjana Krstic
Keyword(s):  
Drug Therapy ◽  
Physical Therapy ◽  
Severe Trauma ◽  
Normal Diet ◽  
Early Rehabilitation ◽  
Oral Feeding ◽  
Case Presentation ◽  
Tissue Edema ◽  
Accident Victim ◽  
The Right

Case presentation This is a case presentation of an eight-year-old boy, a traffic accident victim with severe polytrauma. The boy was admitted to hospital with lacerations and contusion injuries of the left basal frontal and left temporal brain region, moderate brain tissue edema and fracture of the left clavicle which were diagnosed by CT (computer tomography). The boy was in coma (Glasgow Coma Scale - 5). Oral feeding and catheter removal were established after one month. Three months later his state of consciousness improved, he could carry out simple orders, started vocalization and visited ambulance by wheel chair. Speech and independent walking were achieved 4 months after the accident. Physical therapy Physical therapy included: neural-stimulation by Vojta and sclerodermal massage from seventh day. Later on, speech and work therapy were applied. Drug therapy Drug therapy included: muscle relaxants and tranquilizers while orthopedic treatment meant plastic immobilization. Control CT revealed chronic subdural hemathoma in the right frontal-parietal region. The boy could walk, talk, have normal diet, and controlled sphincters four months after severe trauma. Now, he is functional and on the level of moderate mental retardation. Early rehabilitation was extremely important in his recovery.

scholarly journals Baby Death Due to Esophagotracheal Fistula Created by An Alkaline Battery: A Case Report

2018 ◽  
Vol 23 (2) ◽  
pp. 120-122
Author(s):  
Hacer Yaşar Teke ◽  
Muhammet Can ◽  
Tülay Renklidağ ◽  
Nevriye Temel ◽  
Asude Gökmen
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Chest Radiography ◽  
Relevant Literature ◽  
Oral Feeding ◽  
Case Presentation ◽  
Alkaline Battery ◽  
Esophagotracheal Fistula ◽  
Case Presentations ◽  
Esophageal Burn

There is a limited number of case presentations in literature related to esophagus burns and complications as a result of swallowing an alkaline battery. The main purpose of this case presentation was to discuss the autopsy findings of late-developing complications of swallowing an alkali battery in the light of the relevant literature. On the chest radiography of a 9-month old baby with complaints of vomiting for three days, an opacity was observed consistent with a foreign body in the esophagus. Esophagoscopy was applied and the swallowed battery was removed. On the fifth day after the operation, no complication has been observed to oral feeding was started and on the following day the patient was discharged. Four days after discharge, the patient was again brought to hospital with complaints of blood in vomit and was again hospitalized with a diagnosis of chemical esophageal burn. The patient died on the following day....

scholarly journals The “needle re-entry” technique for infrainguinal arterial calcified occlusive lesions

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Takuya Haraguchi ◽  
Yoshifumi Kashima ◽  
Masanaga Tsujimoto ◽  
Tomohiko Watanabe ◽  
Hidemasa Shitan ◽  
...  
Keyword(s):  
Ankle Brachial Index ◽  
Balloon Dilation ◽  
Vascular Wall ◽  
Chronic Total Occlusions ◽  
Needle Penetration ◽  
Rendezvous Technique ◽  
Diffuse Calcification ◽  
Computed Tomography Angiogram ◽  
One Year ◽  
Severe Calcification

Abstract Background Vascular calcification is a predictor of poor clinical outcome during and after endovascular intervention. Guidewire crossing techniques and devices have been developed, but chronic total occlusions (CTOs) with severe calcification often prevent subintimal re-entry. We propose a novel guidewire crossing approach combined needle rendezvous with balloon snare technique, named the “needle re-entry” technique, for treatment of complex occlusive lesions. Main text A 73-year-old female with severe claudication in her right calf with ankle brachial index of 0.62, and a computed tomography angiogram showed a long occlusion with diffuse calcification in superficial femoral artery. She was referred to our department to have peripheral interventions. Since the calcified vascular wall of the lesion prevented the successful re-entry, the “needle re-entry” was performed. First, a retrograde puncture of the SFA, distally to the occlusion, was performed and an 0.018-in. guidewire with a microcatheter was inserted to establish a retrograde fashion. Second, an antegrade 5.0-mm balloon was advanced into a subintimal plane and balloon dilation at 6 atm was maintained. Third, an 18-gauge needle was antegradely inserted from distal thigh to the dilated 5.0-mm balloon. After confirming a balloon rupture by the needle penetration, we continued to insert the needle to meet the retrograde guidewire tip. Then, a retrograde 0.014-in. guidewire was carefully advanced into the needle hole, named the “needle rendezvous” technique. After further guidewire advancement to accomplish a guidewire externalization, the needle was removed. Finally, since the guidewire was passing through the 5.0-mm ruptured balloon, the balloon was withdrawn, and the guidewire was caught with the balloon and successfully advanced into the antegrade subintimal space, named the “balloon snare” technique. After the guidewire was advanced into the antegrade guiding sheath and achieved a guidewire externalization, an endovascular stent graft and an interwoven stent were deployed to cover the lesion. After postballoon dilation, an angiography showed a satisfactory result without complications. No restenosis, reintervention, and limb loss have been observed for one year follow-up period after this technique. Conclusions The “needle re-entry” technique is a useful guidewire crossing technique to revascularize femoropopliteal complex CTOs with severe calcification which prevent the achievement of guidewire crossing with the conventional procedures.

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