A case report of exogenous lipoid pneumonia associated with avocado/soybean unsaponifiables

Abstract Background Exogenous lipoid pneumonia is a rare disease resulting from intra-alveolar accumulation of lipids of mineral, vegetal, or animal origin, that induce a foreign body type of inflammatory reaction in the lungs. Gastroesophageal reflux disease and other esophageal abnormalities have often been associated with this disease. Case presentation We herein report the case of an 83-year-old patient in whom a follow-up chest computed tomography scan, for a lingular consolidation, showed multifocal ground glass and consolidative opacities with areas of low attenuation, suggestive of exogenous lipid pneumonia. The patient had been on piascledine capsules (avocado/soybean unsaponifiables) for 20 years and had a hiatal hernia with documented gastroesophageal reflux disease. After thorough history taking, no other predisposing factors were found. The diagnosis was confirmed using oil red staining of bronchoalveolar lavage showing lipid-laden macrophages and extracellular lipid droplets. Conclusions To our knowledge, this is the first case of ELP secondary to avocado/soybean unsaponifiables in the literature.

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Four-year follow-up of the first case of gastroesophageal reflux disease treated with endoluminal gastroplication in Japan

Journal of Gastroenterology ◽

10.1007/s00535-007-2005-4 ◽

2007 ◽

Vol 42 (4) ◽

pp. 325-326 ◽

Cited By ~ 3

Author(s):

Kazuhide Higuchi ◽

Masatsugu Shiba ◽

Hirotoshi Okazaki ◽

Masahiko Tabuchi ◽

Natsuhiko Kameda ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

First Case ◽

Endoluminal Gastroplication

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Surgical treatment of recalcitrant gastroesophageal reflux disease in patients with systemic sclerosis: a systematic review

Langenbeck s Archives of Surgery ◽

10.1007/s00423-021-02118-8 ◽

2021 ◽

Author(s):

Alberto Aiolfi ◽

Mario Nosotti ◽

Kazuhide Matsushima ◽

Carolina Perali ◽

Cristina Ogliari ◽

...

Keyword(s):

Systematic Review ◽

Systemic Sclerosis ◽

Surgical Treatment ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Current Data ◽

Current Evidence ◽

Increased Risk

Abstract Introduction Gastroesophageal reflux disease (GERD) is frequently seen in patients with systemic sclerosis (SSc). Long-standing GERD may cause esophagitis, long-segment strictures, and Barrett’s esophagus and may worsen pre-existing pulmonary fibrosis with an increased risk of end-stage lung disease. Surgical treatment of recalcitrant GERD remains controversial. The purpose of this systematic review was to summarize the current data on surgical treatment of recalcitrant GERD in SSc patients. Materials and methods A systematic literature review according to PRISMA and MOOSE guidelines. PubMed, EMBASE, and Web of Science databases were consulted. Results A total of 101 patients were included from 7 studies. The age ranged from 34 to 61 years and the majority were females (73.5%). Commonly reported symptoms were heartburn (92%), regurgitation (77%), and dysphagia (74%). Concurrent pulmonary disease was diagnosed in 58% of patients. Overall, 63 patients (62.4%) underwent open fundoplication, 17 (16.8%) laparoscopic fundoplication, 15 (14.9%) Roux en-Y gastric bypass (RYGB), and 6 (5.9%) esophagectomy. The postoperative follow-up ranged from 12 to 65 months. Recurrent symptoms were described in up to 70% and 30% of patients undergoing fundoplication and RYGB, respectively. Various symptoms were reported postoperatively depending on the type of surgical procedures, anatomy of the valve, need for esophageal lengthening, and follow-up. Conclusions The treatment of recalcitrant GERD in SSc patients is challenging. Esophagectomy should be reserved to selected patients. Minimally invasive RYGB appears feasible and safe with promising preliminary short-term results. Current evidence is scarce while a definitive indication about the most appropriate surgical treatment is lacking.

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POSTOPERATIVE DYSPHAGIA AFTER LAPAROSCOPIC FUNDOPLICATION AS A TREATMENT FOR GASTROESOPHAGEAL REFLUX DISEASE

British Journal of Surgery ◽

10.1093/bjs/znab160.061 ◽

2021 ◽

Vol 108 (Supplement_3) ◽

Author(s):

B Carrasco Aguilera ◽

S Amoza Pais ◽

T Diaz Vico ◽

E O Turienzo Santos ◽

M Moreno Gijon ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Surgical Technique ◽

Gastroesophageal Reflux ◽

Hiatal Hernia ◽

Reflux Disease ◽

Laparoscopic Fundoplication ◽

Descriptive Study ◽

Postoperative Dysphagia

Abstract INTRODUCTION Laparoscopic Fundoplication (LF) as a treatment for gastroesophageal reflux disease (GERD) has positive clinical outcomes. However, postoperative dysphagia (PD) may appear as a side effect. Our objective is to analyze PD in patients operated on for LF in our center. MATERIAL AND METHODS Retrospective and descriptive study of patients operated on for GERD from September 1997 to February 2019. RESULTS 248 patients (60.5% men), with a mean age of 49.7 (21-82), were operated. 66.1% of the patients presented associated comorbidities, highlighting obesity (19.8%). 75% manifested typical symptoms, 19% presenting with Barrett’s esophagus. Sliding hiatal, paraesophageal, mixed and complex hernia were diagnosed in 151 (60.9%), 23 (9.3%), 12 (4.8%), and 4 (1.6%) patients, respectively. The LF Nissen was the most frequent technique (91.5%), using a caliper in 46% of the cases. PD was the most frequent symptom, present in 57 (23%) patients. It was resolved with dilation in 9 patients, requiring 6 patients surgical reintervention. In those PD cases, a caliper was used in 28 (49.1%) patients, without finding significant differences between them (P = .586). Nor were there significant differences between PD and obesity (P = .510), type of hiatal hernia (P = .326), or surgical technique (P = .428). After a median follow-up of 50.5 months, quality of life was classified as Visick I-II, III, and IV in 76.6%, 6.9% and 1.2% of the cases, respectively. CONCLUSION No association between PD and the use of calipers, surgical technique or type of hiatal hernia was found in our series.

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THE EFFICACY OF THE DIFFERENT ENDOSCOPIC TREATMENTS VERSUS SHAM, PHARMACOLOGIC OR SURGICAL METHODS FOR CHRONIC GASTROESOPHAGEAL REFLUX DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201800000-65 ◽

2018 ◽

Vol 55 (3) ◽

pp. 296-305 ◽

Cited By ~ 4

Author(s):

Martin Andrés CORONEL ◽

Wanderley Marques BERNARDO ◽

Diogo Turiani Hourneaux de MOURA ◽

Eduardo Turiani Hourneaux de MOURA ◽

Igor Braga RIBEIRO ◽

...

Keyword(s):

Systematic Review ◽

Surgical Treatment ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Meta Analysis ◽

Short Term ◽

Significant Difference ◽

Objective Outcomes

ABSTRACT BACKGROUND: Endoscopic antireflux treatments for gastroesophageal reflux disease (GERD) are still evolving, and most of the published studies address symptom relief in the short-term. Objective - We aimed to perform a systematic review and meta-analysis focused on evaluating the efficacy of the different endoscopic procedures. METHODS: Search was restricted to randomized controlled trials (RCTs) on MedLine, Cochrane, SciELO, and EMBASE for patients with chronic GERD (>6 months), over 18 years old and available follow up of at least 3 months. The main outcome was to evaluate the efficacy of the different endoscopic treatments compared to sham, pharmacological or surgical treatment. Efficacy was measured by different subjective and objective outcomes. RESULTS: We analyzed data from 16 RCT, totaling 1085 patients. The efficacy of endoscopic treatments compared to sham and proton pump inhibitors (PPIs) treatment showed a significant difference up to 6 months in favor of endoscopy with no heterogeneity (P<0.00001) (I2: 0%). The subgroup analysis showed a statistically significant difference up to 6 months in favor of endoscopy: endoscopy vs PPI (P<0.00001) (I2: 39%). Endoscopy vs sham (P<0.00001) (I2: 0%). Most subjective and objective outcomes were statistically significant in favor of endoscopy up to 6 and 12 months follow up. CONCLUSION: This systematic review and meta-analysis shows a good short-term efficacy in favor of endoscopic procedures when comparing them to a sham and pharmacological or surgical treatment. Data on long-term follow up is lacking and this should be explored in future studies.

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Do Eosinophil Numbers Differentiate Eosinophilic Esophagitis from Gastroesophageal Reflux Disease?

Archives of Pathology & Laboratory Medicine ◽

10.5858/134.6.815 ◽

2010 ◽

Vol 134 (6) ◽

pp. 815-825

Author(s):

Muriel Genevay ◽

Laura Rubbia-Brandt ◽

Anne-Laure Rougemont

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Eosinophilic Esophagitis ◽

Reflux Disease ◽

Eosinophilic Infiltration ◽

Treatment Modalities ◽

Esophageal Mucosa ◽

American Gastroenterological Association ◽

National Library

Abstract Context.—Although the healthy esophageal mucosa contains no eosinophils, eosinophilic infiltration is observed in 2 major clinicopathologic settings: gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EE). The prevalence of EE is increasing in many countries, and this increase seems only partly to be due to a better awareness of the pathology, following the relatively recent description of EE. Gastroesophageal reflux disease and EE represent 2 entities that do not respond to the same treatment modalities and, thus, need to be distinguished. However, diagnostic criteria of EE have been defined arbitrarily, and the more recent articles tend to prove that the overlap with GERD is probably greater than initially believed, leading the authors to advise strict exclusion of GERD before considering the diagnosis of EE. Objectives.—To provide pathologists with the currently proposed histologic criteria of GERD and EE, to stress the need to combine these criteria with clinical data and endoscopic findings, and to outline the remaining controversies. Data Sources.—This review is based on selected articles identified by a PubMed (US National Library of Medicine, Bethesda, Maryland) search of the literature in English for GERD and EE, a recent review by the American Gastroenterological Association (Bethesda), the Proceedings of the First International Gastrointestinal Eosinophil Research Symposium, and the authors' experience. Conclusions.—Proper identification of the etiology of eosinophilic infiltration of the esophagus allows accurate medical or surgical treatment and follow-up. Eosinophilic esophagitis and GERD diagnoses require integration of the histologic findings with the clinical and endoscopic data.

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A 10-Year Follow-Up of a Randomized Prospective Study of 2 Treatments for Chronic Rhinosinusitis Without Nasal Polyps and Investigation of the Impact of Gastroeosophageal Reflux Disease in the Resistance to Treatment

Ear Nose & Throat Journal ◽

10.1177/0145561319892460 ◽

2019 ◽

pp. 014556131989246

Author(s):

Jerome R. Lechien ◽

Gersende Debie ◽

Virginie Mahillon ◽

Marie-Paule Thill ◽

Alexandra Rodriguez ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Chronic Rhinosinusitis ◽

Reflux Disease ◽

Nasal Polyps ◽

Sinus Surgery ◽

Amoxicillin Clavulanate ◽

The Impact

Objectives: To compare the 2 long-term medical strategies in chronic rhinosinusitis without nasal polyps (CRSnNP) and to identify the role of gastroesophageal reflux disease (GERD) and Helicobacter pylori as factors of treatment failure. Material and Methods: Fifty-seven patients with CRSnNP were randomized into 2 therapeutic groups. The first group was treated with 4 weeks of amoxicillin/clavulanate and a short course of oral steroids. The second group received 8 weeks of clarithromycin. Sinonasal Outcome Test-20 (SNOT-20) and Lund and Mackay scores were assessed at baseline and after treatment, and GERD Health-Related Quality of Life (GERD-HRQL) questionnaire was evaluated in all patients. Patients with a GERD-HRQL score >8 received esogastroscopy and H pylori detection. Patients were followed during a 10-year period for clinical course and GERD evolution. The 10-year evolution of patients was described in terms of recurrence, medical, and surgical treatments. Results: Thirty-seven patients completed the study; SNOT-20 and Lund and Mackay scores similarly improved in both groups. Amoxicillin/clavulanate group had significantly more adverse reactions than the clarithromycin group (P = .03). After the therapeutic course, 35% (amoxicillin/clavulanate) and 41% (clarithromycin) of patients needed functional endoscopic sinus surgery (FESS). During the long-term follow-up, 54% (amoxicillin/clavulanate) and 40% (clarithromycin) of patients had late CRSnNP recurrence; FESS was performed in less than 15% of cases of recurrence. Gastroesophageal reflux disease complaint’s severity was associated with late recurrence of CRSnNP. Conclusion: Amoxicillin/clavulanate and clarithromycin would be competitive treatments for CRSnNP. Gastroesophageal reflux disease seems to be a negative factor for treatment response and recurrence.

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Long-term follow-up study of the Stretta procedure for the treatment of gastroesophageal reflux disease

Surgical Endoscopy ◽

10.1007/s00464-003-9181-y ◽

2004 ◽

Vol 18 (10) ◽

pp. 1475-1479 ◽

Cited By ~ 39

Author(s):

A. Torquati ◽

H. L. Houston ◽

J. Kaiser ◽

M. D. Holzman ◽

W. O. Richards

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Follow Up Study ◽

Stretta Procedure ◽

Long Term Follow Up

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Tu1934 Follow-up After pH-Metry and pH-Impedance in Pediatric Gastroesophageal Reflux Disease

Gastroenterology ◽

10.1016/s0016-5085(13)63290-4 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-884

Author(s):

Rachel J. van der Pol ◽

Marloes van den Ouweland ◽

Clara M. Loots ◽

Yvan Vandenplas ◽

Marc A. Benninga ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Ph Metry

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Medical Image Analysis Based on Endoscopic Radiofrequency Ablation Catheter System on the Treatment of Gastroesophageal Reflux Disease Related Extra-Esophageal Symptoms

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2019.2796 ◽

2019 ◽

Vol 9 (8) ◽

pp. 1765-1769

Author(s):

Wei-Tao Liang ◽

Tao Li ◽

Ji-Min Wu ◽

Zhi-Wei Hu ◽

Chao Yan ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Statistical Significance ◽

Medical Image Analysis ◽

Final Analysis ◽

Symptom Scores ◽

Endoscopic Radiofrequency Ablation

Objective: Gastroesophageal reflux disease is easily missed on X-ray or even computer tomography. This study was to evaluate the endoscopic imaging for the radiofrequency ablation (RA) on the diagnosis and management of gastroesophageal reflux disease related extra-esophageal symptoms. Methods: From January 2011, to January 2012, we allocated 51 patients to LTF and 47 to RA procedure. Primary outcome measures, including symptom scores of globus hysterics, chest pain, belching, hiccup, cough and asthma as well as proton pump inhibitors (PPIs) use, were analyzed after 5-year follow-up. Results: There were 90 patients following RA procedure (N = 40) or LTF (N = 50) that completed the designated 5-year follow-up and were included in the final analysis. At the end of 5-year follow-up, the symptom scores were all significantly decreased as compared with the corresponding values before the two procedures in both groups (p < 0.05). Moreover, the improvement in symptom scores between the two groups did not achieve statistical significance. After RA procedure and LTF, 18 (45%) and 32 (64%) patients in each group achieved complete PPIs therapy independence (p = 0.071). Comparing with LTF, however, the RA procedure had a higher risk of reoperation (17.5% vs. 0, p = 0.002). Conclusion: Comparing with LTF in controlling GERD-related extra-esophageal symptoms, RA procedure can offer equivalent relief on symptoms and PPIs independence. However, it has a higher risk of reoperation during the 5 years follow-up.

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