The Significance of Pancreatic Acinar Metaplasia at the Lower Esophagus

Objectives: There are reports describing the relationship between baseline impedance level and esophageal mucosal integrity at endoscopy, such as erosive and nonerosive reflux esophagitis. However, many children with symptoms of gastroesophageal reflux disease have normal findings or minor changes on esophagogastroduodenoscopy. We aimed to examine whether modest changes at esophagogastroduodenoscopy can be evaluated and correlated with esophageal multichannel intraluminal impedance monitoring. Methods: Patients (ages 0–17 years) with upper gastrointestinal symptoms who underwent combined esophagogastroduodenoscopy and multichannel intraluminal impedance monitoring at the Women’s and Children’s Hospital, Adelaide, Australia, between 2014 and 2016 were retrospectively studied and the following data were collected and used for analysis: demographics, multichannel intraluminal impedance data, included baseline impedance. Endoscopic findings were classified by modified Los Angeles grading, Los Angeles N as normal, Los Angeles M as with minimal change such as the erythema, pale mucosa, or friability of the mucosa following biopsy. Patients on proton pump inhibitor were excluded. Results: Seventy patients (43 boys; 61%) were enrolled with a mean age of 7.9 years (range 10 months to 17 years). Fifty-one patients (72.9%) were allocated to Los Angeles N, while Los Angeles M was evident in 19 patients (27.1%). Statistically significant differences were observed in the following parameters: frequency of acid and nonacid reflux and baseline impedance in channels 5 and 6. The median values of the data were 18.3 episodes, 16.0 episodes, 2461.0 Ω, 2446.0 Ω in Los Angeles N, 36.0 episodes, 31.0 episodes, 2033.0 Ω, 2009.0 Ω in Los Angeles M, respectively. Conclusion: Lower baseline impedance is helpful in predicting minimal endoscopic changes in the lower esophagus. A higher frequency of acid and nonacid reflux episodes was also predictive of minimal endoscopic change in the lower esophagus.

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Successful thoracoscopic treatment for tracheoesophageal fistula and esophageal atresia of communicating bronchopulmonary foregut malformation group IB with dextrocardia: a case report of VACTERL association

Surgical Case Reports ◽

10.1186/s40792-020-01099-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Toshio Harumatsu ◽

Tatsuru Kaji ◽

Ayaka Nagano ◽

Mayu Matsui ◽

Masakazu Murakami ◽

...

Keyword(s):

Tracheoesophageal Fistula ◽

Thoracoscopic Surgery ◽

Anastomotic Site ◽

Vacterl Association ◽

Lower Esophagus ◽

Intralobar Sequestration ◽

Working Space ◽

Esophageal Anastomosis ◽

Cardiac Condition ◽

Foregut Malformation

Abstract Background A communicating bronchopulmonary foregut malformation (CBPFM) group IB is very rare congenital malformation. Group IB is associated with tracheoesophageal fistula and esophageal atresia (TEF-EA) and a portion of one lung arisen from the esophagus (Gerle et al. in N Engl J Med. 278:1413–1419, 1968). The coexistence of TEF-EA and dextrocardia is also a rare and challenging setting for repair of TEF-EA. Therefore, the thoracoscopic surgery for TEF-EA require the technical devise because of the small operative space. We herein report a rare case of CBPFM group IB with intralobar sequestration of lung and a successful performing of thoracoscopic surgery for EA with dextrocardia in VACTERL association. Case presentation A 2.2-kg term male neonate was born with an anal atresia, coarctation of the aorta, TEF-EA, renal anomalies, radial hemimelia, limb abnormalities (VACTERL association) and hypoplasia of the right lung with dextrocardia. The patient developed respiratory distress after admission. A two-stage operation for the TEF-EA was planned because of multiple anomalies and cardiac condition. In the neonatal period, esophageal banding at the gastroesophageal junction and gastrostomy were performed to establish enteral nutrition. After gaining body weight and achieving a stable cardiac condition, thoracoscopic surgery for TEF-EA was performed. The thoracoscopic findings revealed a small working space due to dextrocardia. To obtain a sufficient working space and to perform secure esophageal anastomosis, an additional 3-mm assistant port was inserted. To close the upper and lower esophagus, anchoring sutures of the esophagus were placed and were pulled to suspend the anastomotic site. Esophageal anastomosis was successfully performed. An esophagogram after TEF-EA surgery showed the connection between the lower esophagus and right lower lung. The definitive diagnosis was CBPFM group IB with intralobar sequestration. The thoracoscopic surgery was performed again for establishing oral intake. After transection of the bronchoesophageal fistula, the patient could perform oral feeding without pneumonia or respiratory distress. Conclusions CBPFM type IB with intralobar sequestration is a rare condition. CBPFM type IB should be considered for a patients with respiratory symptom after radical operation for TEF-EA. In the present case, suspending the anastomotic site was effective and useful in thoracoscopic surgery for a TEF-EA patient with dextrocardia.

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Methotrexate‐associated proliferative disorder in the lower esophagus extending to the gastroesophageal junction: A case report

DEN Open ◽

10.1002/deo2.14 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Yuki Hojo ◽

Masafumi Takatsuna ◽

Satoshi Ikarashi ◽

Hiroteru Kamimura ◽

Rika Kimura ◽

...

Keyword(s):

Case Report ◽

Gastroesophageal Junction ◽

Lower Esophagus

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Endoscopic evaluation of gastric cancer infiltrating the lower esophagus

Surgical Endoscopy ◽

10.1007/bf02281082 ◽

1992 ◽

Vol 6 (2) ◽

pp. 62-67 ◽

Cited By ~ 2

Author(s):

K. Takeshita ◽

H. Habu ◽

N. Saito ◽

T. Honda ◽

M. Iida ◽

...

Keyword(s):

Gastric Cancer ◽

Endoscopic Evaluation ◽

Lower Esophagus

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Delineation of the Normal Esophagus at Computed Tomography

Acta Radiologica Diagnosis ◽

10.1177/028418518502600604 ◽

1985 ◽

Vol 26 (6) ◽

pp. 665-669 ◽

Cited By ~ 2

Author(s):

L. Samuelsson ◽

U. Tylén

Keyword(s):

Main Bronchus ◽

Anterior Wall ◽

Middle Part ◽

Left Main ◽

Lower Esophagus ◽

Normal Esophagus ◽

Mediastinal Disease ◽

Normal Men ◽

The Relationship ◽

Upper Third

It has been accepted by many that the esophagus in its entire length is easy to delineate at CT in most patients due to surrounding fat planes. As this is not the experience of the present authors, the CT of the thorax in 100 normal men and women without mediastinal disease and in good nutritional status was reviewed, to record the relationship between the esophagus and neighbouring structures. In the upper third of the esophagus there is almost never a definite border between its wall and that of the trachea, while a separating border or even a fat plane can be seen to the spine in between 25 and 50 per cent of those tested. The vessels, as a rule, have a fat plane towards the esophagus. The middle part of the esophagus has the same intimate relationship to the trachea and left main bronchus, i.e. almost never any separating border. Two thirds of the cases have no border to the upper part of the pericardium (left atrium), while about 70 per cent have a border or fat plane towards the aorta. The middle and lower third of the esophagus has, as a rule, a distinct border or fat plane to the spine. In about 50 per cent of the patients the anterior wall of the lower esophagus is separable from the pericardium.

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Submucosal Tunneling Diverticular Septotomy (Stesd) by Diverticular Peroral Endoscopic Myotomy (D-Poem) for Treatment of Diverticula of the Middle and Lower Esophagus

10.1055/s-0041-1724539 ◽

2021 ◽

Author(s):

S Nagl ◽

SK Goelder ◽

A Ebigbo ◽

H Messmann

Keyword(s):

Peroral Endoscopic Myotomy ◽

Lower Esophagus ◽

Endoscopic Myotomy

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Mechanism of pellet egestion in great-horned owls (Bubo virginianus)

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1976.231.6.1824 ◽

1976 ◽

Vol 231 (6) ◽

pp. 1824-1829 ◽

Cited By ~ 23

Author(s):

GE Duke ◽

OA Evanson ◽

PT Redig ◽

DD Rhoades

Keyword(s):

Gastrointestinal Motility ◽

Strain Gauge ◽

Abdominal Muscles ◽

Lower Esophagus ◽

Bubo Virginianus ◽

Final Shape ◽

Bipolar Electrodes ◽

Gastric Contractions

To study the mechanism of oral pellet egestion in great-horned owls, bipolar electrodes and strain-gauge transducers were chronically implanted in the esophagus, muscular stomach, and duodenum of six owls. Recordings from conscious owls plus simultaneous radiographic observations revealed characteristic gastrointestinal motility patterns associated with egestion. Beginning at about 12 min before egestion, gastric contractions formed the final shape of the pellet and pushed it into the lower esophagus. The pellet was moved out of the esophagus by antiperistalsis during the last 8--10 s before egestion. During pellet egestion, contractions of abdominal muscles were not detected. Pellet egestion appears to be unlike either emesis in mammals with a simple stomach or regurgitation in ruminants.

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The lower esophagus and glucagon

Annals of Emergency Medicine ◽

10.1016/s0196-0644(80)80229-0 ◽

1980 ◽

Vol 9 (11) ◽

pp. 577-579 ◽

Cited By ~ 7

Author(s):

K.A. Handal ◽

William Riordan ◽

J. Siese

Keyword(s):

Lower Esophagus

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