ESOFAGITIS NECROTIZANTE AGUDA (ENA): REPORTE DE CASO

Introducción: La esofagitis necrotizante aguda (ENA) es una entidad patológica sumamente rara, cuya patogénesis no se ha identificado hasta la actualidad, pero se la asocia con la hipoperfusión tisular en pacientes de la tercera edad con antecedentes de patologías cardiovasculares (CV) o metabólicas. La ENA es identificada por endoscopia digestiva en ciertos pacientes con antecedentes de riesgo CV, quienes han presentado sintomatología como sangrado digestivo alto, disfagia súbita, epigastralgía intensa, vómitos, entre otros. Objetivo: describir un caso clínico de esofagitis necrotizante aguda, una entidad clínica poco estudiada, el manejo y la evolución clínica de la paciente. Caso clínico: paciente de 87 años con antecedentes de diabetes e hipertensión arterial, ingresada al Servicio de Medicina Interna por descompensación glicémica, quien en su estancia hospitalaria presentó disfagia súbita por lo que se realizó endoscopía digestiva alta, encontrándose un cuadro compatible con esofagitis necrotizante aguda, fue manejada con dieta absoluta, nutrición parenteral total, hidratación e inhibidores de la bomba de protones, siendo su evolución satisfactoria. Conclusiones: Se debería sospechar de ENA en pacientes adultos mayores quienes presentan sintomatología esófago-gástrica aguda y comorbilidades asociadas. Palabras clave: enfermedades del esófago, esofagitis, endoscopia, estenosis esofágica ABSTRACT Introduction: Acute necrotizing esophagitis (ENA) is an extremely rare pathological entity, the pathogenesis of which has not been identified to date, but it is associated with tissue hypoperfusion in elderly patients with a history of Cardiovascular disease (CVD) or metabolic pathologies. ENA is identified by digestive endoscopy in certain patients with a history of CVD risk, who have presented symptoms such as upper gastrointestinal bleeding, sudden dysphagia, intense epigastric pain, vomiting, among others. Objective: to describe a clinical case of acute necrotizing esophagitis, a little-studied clinical entity, the management and the clinical evolution of the patient. Clinical case: 87-year-old patient with a history of diabetes and arterial hypertension, admitted to the Internal Medicine Service due to glycemic decompensation, who during his hospital stay presented sudden dysphagia for which an upper gastrointestinal endoscopy was performed, finding a picture compatible with acute necrotizing esophagitis, was managed with absolute diet, total parenteral nutrition, hydration and proton pump inhibitors, and her evolution was satisfactory. Conclusions: ENA should be suspected in older adult patients who present acute esophageal-gastric symptoms and associated comorbidities. Keywords: diseases of the esophagus, esophagitis, endoscopy, esophageal stricture

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Medication Bezoar Causing acute Gastric Outlet Obstruction: A Case Report

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v33i3.28063 ◽

2016 ◽

Vol 33 (3) ◽

pp. 177-180 ◽

Cited By ~ 1

Author(s):

Md Abdul Mazid

Keyword(s):

Gastric Outlet Obstruction ◽

Epigastric Pain ◽

Outlet Obstruction ◽

Uneventful Recovery ◽

Upper Gastrointestinal Endoscopy ◽

Abdominal Ultrasonography ◽

Life Threatening ◽

History Of ◽

Upper Gastrointestinal ◽

Made In

Medication bezoars are rare and are composed of medications and/or medication vehicles. Rarely, medication bezoars can cause serious problems due to complications such as perforation, obstruction, haemorrhage. A 60 years old woman presented with 10 days history of epigastric pain, weakness and postprandial non-bilious vomiting. Her abdominal ultrasonography showed strong post acoustic shadow noted within 1st part of duodenum possibly foreign body. Upper gastrointestinal endoscopy was performed and a bezoar of tablet of aluminum hydroxide was extracted. The patient had uneventful recovery. Acute gastric outlet obstruction is relatively uncommon and mostly due to foreign bodies related to food impaction, with meat being the most frequent culprit. The diagnostic approach to acute gastric outlet obstruction is similar to other cause of GOO. However, therapeutic options differ for each patient. The diagnosis should be made in prompt time to prevent life threatening complications due obstruction and/or effect of medication forming bezoar.J Bangladesh Coll Phys Surg 2015; 33(3): 177-180

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CandidaEsophagitis in an Immunocompetent Pregnant Woman

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/s106474499300033x ◽

1993 ◽

Vol 1 (3) ◽

pp. 149-152 ◽

Cited By ~ 1

Author(s):

Jeffrey S. Greenspoon ◽

Seth Kivnick

Keyword(s):

Human Immunodeficiency Virus ◽

Weight Loss ◽

Candida Albicans ◽

Gastrointestinal Endoscopy ◽

Epigastric Pain ◽

Upper Gastrointestinal Endoscopy ◽

Second Trimester ◽

Increased Risk ◽

Immunodeficiency Virus ◽

Upper Gastrointestinal

Background:Nausea and vomiting are common during the first half of pregnancy and usually require only supportive measures. When symptoms are progressive and weight loss occurs, treatable causes should be sought by means of upper gastrointestinal endoscopy. We report a case of an immunocompetent gravida with invasiveCandida albicansesophagitis.Case:The immunocompetent primigravida developed progressive nausea, vomiting, epigastric pain, and a 4.1 kg weight loss during the second trimester of pregnancy. Treatment with metoclopramide and cimetidine for presumed gastroesophageal reflux was not effective. The patient had normal T-cell CD4 and CD8 subsets and was human immunodeficiency virus (HIV) antibody negative. Upper gastrointestinal endoscopy revealedC. albicansesophagitis which was treated with oral nystatin. The esophagitis had resolved completely when reassessed postpartum. The use of histamine2blockers is associated with an increased risk for fungal esophagitis and may have been a contributing cause in this case.Conclusion:Pregnant patients with persistent nausea, vomiting, and weight loss should be evaluated by endoscopy for fungal esophagitis.

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Acute Gastric Volvulus on Hiatal Hernia

Case Reports in Surgery ◽

10.1155/2020/4141729 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Abdessamad EL KAOUKABI ◽

Mohamed MENFAA ◽

Samir HASBI ◽

Fouad SAKIT ◽

Abdelkrim CHOHO

Keyword(s):

Hiatal Hernia ◽

Gastrointestinal Endoscopy ◽

Epigastric Pain ◽

Gastric Volvulus ◽

Upper Gastrointestinal Endoscopy ◽

Rare Entity ◽

Midline Laparotomy ◽

Acute Gastric Volvulus ◽

Upper Abdominal ◽

Upper Gastrointestinal

The gastric volvulus is defined as an abnormal rotation of all or part of the stomach around one of its axes, creating the conditions of an upper abdominal obstruction with gastric dilation and risk of strangulation. It is a rare entity that requires a surgical treatment, and its diagnosis is often delayed due to frequently aspecific symptoms. We will describe the observation of a 62 year old patient who presented to the emergency department for acute epigastric pain with dyspnea. The thoracoabdominal CT has demonstrated a stasis stomach on pyloric obstacle evoking a gastric torsion. An upper gastrointestinal endoscopy (EGD) and an upper gastrointestinal contrast made it possible to diagnose an acute gastric volvulus on hiatal hernia. A midline laparotomy was performed with detorsion of the stomach and repair of the hiatal hernia. The patient recovered gradually and was discharged on the sixth postoperative day. Three months after the operation, the patient remained asymptomatic.

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Palliation with Oesophageal Metal Stent of Pseudoachalasia from Gastric Carcinoma at the Cardia: A Case Report

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2009/791627 ◽

2009 ◽

Vol 2009 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Salvatore Maria Antonio Campo ◽

Roberto Lorenzetti ◽

Marina de Matthaeis ◽

Cesare Hassan ◽

Angelo Zullo ◽

...

Keyword(s):

Old Age ◽

Iron Deficiency Anaemia ◽

Gastrointestinal Endoscopy ◽

Barium Swallow ◽

Upper Gastrointestinal Endoscopy ◽

Metal Stent ◽

History Of ◽

Upper Gastrointestinal ◽

Progressive Dysphagia

We present an 82-year-old woman with a 3-month history of progressive dysphagia and a normal initial upper gastrointestinal endoscopy. The diagnosis of pseudoachalasia was suspected by oesophageal manometric and barium swallow studies, and confirmed by biopsies revealing an intestinal type carcinoma of the stomach at a repeated endoscopy. In view of the history of heart disease, diabetes, and old age, this patient was treated by a partially covered Ultraflex self-expanding metal stent (Boston Scientific, Natick, MA, USA) placed into the oesophageal body with no direct complications and obtaining the relief from dysphagia. During the 11-month follow-up she was treated for an iron deficiency anaemia due to reflux oesophagitis with ulcerations in the oesophageal body and died from myocardial infarction. According to the localization of the cancer, the old age, and the presence of comorbidities, we should recommend the insertion of a partially covered self-expanding metal stent as a reasonable palliative treatment in selected subjects with pseudoachalasia.

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A rare cause of abdominal pain with fever

BMJ Case Reports ◽

10.1136/bcr-2018-228401 ◽

2019 ◽

Vol 12 (3) ◽

pp. e228401

Author(s):

Diana Martins Oliveira ◽

Catarina Correia ◽

Flávia Cunha ◽

Patrícia Dias

Keyword(s):

Gastrointestinal Endoscopy ◽

Acute Cholangitis ◽

Magnetic Resonance Cholangiopancreatography ◽

Upper Gastrointestinal Endoscopy ◽

Laboratory Findings ◽

Reactive Protein ◽

Elevated Liver Enzymes ◽

History Of ◽

Lemmel’S Syndrome ◽

Upper Gastrointestinal

An 89-year-old man presented to the emergency department with a 1-month history of upper right quadrant pain, worsened in the last 3 days and accompanied by fever and chills. On physical examination, he had scleral icterus and right upper quadrant tenderness. Laboratory findings showed hyperbilirubinemia, elevated liver enzymes and C reactive protein. The patient was admitted, suspecting of an acute cholangitis and started on antibiotics. An upper gastrointestinal endoscopy revealed the presence of a juxtapapillary diverticulum in the second portion of the duodenum, which was confirmed by a magnetic resonance cholangiopancreatography, along with upstream biliary tract ectasia. The imaging findings allowed us to diagnose a Lemmel’s syndrome. Due to potential surgical risk, we decided for a conservative approach. The patient had a favourable course and was discharged home.

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Bouveret-szindróma

Orvosi Hetilap ◽

10.1556/650.2021.32294 ◽

2021 ◽

Vol 162 (49) ◽

pp. 1982-1986

Keyword(s):

Gastric Outlet Obstruction ◽

Elderly Women ◽

Epigastric Pain ◽

Outlet Obstruction ◽

Abdominal Ultrasound ◽

Therapeutic Options ◽

Upper Gastrointestinal Endoscopy ◽

Rare Form ◽

Bouveret Syndrome ◽

Upper Gastrointestinal

Összefoglaló. A Bouveret-szindróma egy bilioenteralis fistulán keresztül a vékonybélbe – az esetek 85%-ában a duodenumba – jutó nagy epekő okozta bélelzáródást jelenti. Leggyakrabban idős nők körében fordul elő. Jelen közleményünk célja e kórkép tüneteinek, diagnosztikájának és terápiás lehetőségeinek ismertetése egy esetbemutatás kapcsán. A 79 éves nőbeteg felvételi hasi panaszainak hátterében típusos gyomorkimenet-obstrukciós szindrómát okozó, a duodenumban beékelődött epekő, Bouveret-szindróma igazolódott. A diagnózist az elvégzett natív hasi röntgen és hasi ultrahangvizsgálatok már felvetették, de megerősítésére további képalkotó vizsgálatot (hasi CT) és endoszkópos beavatkozást végeztünk. Ezt követően sebészeti beavatkozás történt, melynek során a cholecystoduodenalis fistula zárása és az epekő eltávolítása után a beteg gyógyultan távozott. Közleményünkben a diagnózisfelállítás idejének fontosságáról, illetve a terápiás lehetőségekről számolunk be, valamint szeretnénk felhívni a figyelmet az epekő okozta gyomorürülési zavar ezen ritka formájára. Orv Hetil. 2021; 162(49): 1982–1986. Summary. Bouveret syndrome is a rare form of bowel obstruction resulting to the small intestine – in 85% of the cases to the duodenum – caused by a gallstone from a bilioenteral fistula. It occurs most commonly in elderly women. The aim of the present study is to describe the symptoms, diagnostic and therapeutic options of Bouveret syndrome due to our case report. The background of epigastric pain of the 79-year-old woman was the typical gastric outlet obstruction syndrome caused by Bouveret syndrome with an impacted gallstone into the duodenum. This diagnosis was suggested by abdominal X-ray and abdominal ultrasound; however, it was confirmed with abdominal computer tomography and upper gastrointestinal endoscopy. This was followed by surgical intervention to close the cholecystoduodenal fistula and remove the gallstone, finally the cured patient was discharged. In our study, we summarize the importance of timely diagnosis and therapeutic options, respectively, furthermore, draw attention to this rare form of gallstone-caused gastric outlet obstruction syndrome. Orv Hetil. 2021; 162(49): 1982–1986.

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Periesophageal Pseudoaneurysms: Rare Cause of Refractory Bleeding Treated with Transarterial Embolization

Case Reports in Gastrointestinal Medicine ◽

10.1155/2016/1456949 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

Divyanshoo R. Kohli ◽

Rachit D. Shah ◽

Daniel J. Komorowski ◽

George B. Smallfield

Keyword(s):

Lupus Erythematosus ◽

Transarterial Embolization ◽

Left Gastric Artery ◽

Massive Bleeding ◽

Upper Gastrointestinal Endoscopy ◽

Angiographic Embolization ◽

First Case ◽

Arterial Bleeding ◽

History Of ◽

Upper Gastrointestinal

A 43-year-old female with history of systemic lupus erythematosus, prior cytomegalovirus esophagitis treated with ganciclovir, and long segment Barrett’s esophagus (Prague class C8 M9) with high grade dysplasia treated with radiofrequency ablation presented to the hospital with hematemesis. An upper gastrointestinal endoscopy showed multiple esophageal ulcers with active arterial spurting which could not be controlled with endoscopic interventions including placement of hemostatic clips. An emergent angiogram demonstrated actively bleeding saccular dilations (pseudoaneurysms) in the esophageal branches of the lower thoracic aorta as well as left gastric artery for which gelfoam and coil embolization was initially successful. Due to recurrence of massive bleeding, she subsequently underwent emergent esophagectomy and bipolar exclusion. Pathology demonstrated submucosal hemorrhage, esophagitis with dysplastic Barrett’s mucosa, and an ulcer containing cytomegaloviral inclusions. We report the first case of arterial bleeding from periesophageal pseudoaneurysms as well as use of angiographic embolization for arterial bleeding in the esophagus.

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Upper Gastrointestinal Endoscopy Detection of Synchronous Multiple Primary Cancers in Esophagus and Stomach: Single Center Experience from China

Gastroenterology Research and Practice ◽

10.1155/2012/432367 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Rui Wang ◽

Mo-Jin Wang ◽

Jin-Lin Yang ◽

Cheng-Wei Tang

Keyword(s):

Squamous Cell ◽

Endoscopic Examination ◽

Clinicopathological Features ◽

Multiple Primary Cancers ◽

Upper Gastrointestinal Endoscopy ◽

Simultaneous Exposure ◽

Single Center Experience ◽

Multiple Primary ◽

History Of ◽

Upper Gastrointestinal

The present study was undertaken to clarify the prevalence and clinicopathological features of synchronous multiple primary cancers (SMPCs) under upper gastrointestinal endoscopic examination. We enrolled 45,032 consecutive patients who underwent upper gastrointestinal endoscopic examination for digestive disease from January 2006 to December 2007 in our hospital and analyzed the clinicopathological features of SMPCs in esophagus and stomach. SMPCs are defined as two or over two different cancerous lesions developing in the same or other organs within 6 months. SMPCs were identified in 46 patients (0.1%). The gender ratio was 5.6 : 1 (male/female) and the mean age was 59.4 years. Synchronous esophageal and gastric cancers were the most frequent, being seen in 32 patients (0.07%). The most common histological types of SMPCs were squamous cell carcinoma in esophagus and adenocarcinoma in stomach, respectively. There were 27 (59%) SMPCs patients who had the history of simultaneous exposure to tobacco smoking and alcohol drinking. Additionally, 32 (78%) esophageal squamous cell cancers were associated with tobacco use. And 23 adenocarcinomas of the stomach were associated withHelicobacter pyloriinfection.

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Unusual case of upper gastrointestinal haemorrhage secondary to a ruptured gastroduodenal artery pseudoaneurysm: case presentation and literature review

BMJ Case Reports ◽

10.1136/bcr-2020-236463 ◽

2020 ◽

Vol 13 (11) ◽

pp. e236463

Author(s):

Gasim Ahmed ◽

Mehsim Abid ◽

Sharath Hosmane ◽

Smitha Mathew

Keyword(s):

Epigastric Pain ◽

Gastrointestinal Haemorrhage ◽

Gastroduodenal Artery ◽

Laboratory Evaluation ◽

Blood Collection ◽

Upper Gastrointestinal Endoscopy ◽

Amylase Level ◽

Dark Blood ◽

Artery Pseudoaneurysm ◽

Upper Gastrointestinal

Pseudoaneurysm rupture of the gastroduodenal artery (GDA) is life-threatening and can present as an acute upper gastrointestinal haemorrhage. Here, we present a case of upper gastrointestinal haemorrhage arising from a ruptured GDA pseudoaneurysm. A 56-year-old woman presented acutely with haematemesis. She reported ongoing upper epigastric pain for a few weeks. Laboratory evaluation revealed severe microcytic hypochromic anaemia (haemoglobin, 69 g/L; normal, 120–140 g/L) and a mildly raised serum amylase level. Upper gastrointestinal endoscopy revealed dark blood collection between the rugae of the distal stomach. An abdominal CT scan detected a homogeneously enhancing rounded lesion arising from the GDA adjacent to the second part of the duodenum. The median arcuate ligament was causing stenosis of the coeliac axis origin. The diagnosis of haematemesis secondary to a ruptured GDA pseudoaneurysm was confirmed by mesenteric angiography, and aneurysmal embolisation was done. The haemoglobin level stabilised after aneurysmal embolisation.

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Helicobacter pylori Infection: Clinical, Endoscopic, and Histological Findings in Lebanese Pediatric Patients

International Journal of Pediatrics ◽

10.1155/2020/4648167 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

F. AL Kirdy ◽

M. Rajab ◽

N. El-Rifai

Keyword(s):

Helicobacter Pylori ◽

Gastrointestinal Endoscopy ◽

Pediatric Patients ◽

Epigastric Pain ◽

Demographic Data ◽

Upper Gastrointestinal Endoscopy ◽

Histopathological Findings ◽

Increased Risk ◽

H Pylori ◽

Upper Gastrointestinal

Background. Helicobacter pylori (H. pylori) is a common and universally distributed bacterial infection. However, in children, active gastritis and ulcer are rarely seen. Objectives. The aims of this study were to establish the prevalence of H. pylori infection and to compare the clinical, endoscopic, and histopathological findings between infected and noninfected pediatric patients at Makassed General Hospital. Methods. Patients aged between 1 month and 17 years who underwent upper gastrointestinal endoscopy from January 2011 to January 2017 were included. The diagnosis of H. pylori was confirmed by a CLO test and/or its presence on biopsy specimens. Demographic data, clinical characteristics, endoscopic and histopathological findings, and gastritis score were recorded retrospectively. Results. During the study period, 651 children underwent upper gastrointestinal endoscopy. The main indication was abdominal pain (61%). The prevalence of H. pylori infection was 16.5%. The infection was most commonly seen among children aged between 6 and 10 years (43%). A large number of family members were associated with increased risk of infection (4.8±1.5 versus 5.2±1.8; p<0.05). Epigastric pain was more associated with H. pylori (61.3% versus 14.6% in noninfected patients; p<0.05). Nodular gastritis was commonly seen in infected patients (41.5% vs. 7.9%; p<0.05). Mild and moderate gastritis was seen more in infected versus noninfected patients (mild: 53.8% vs. 14%; moderate: 27.4% vs. 2.4%, respectively). Conclusion. Although epigastric pain was associated with H. pylori, other diagnoses should be considered since the infection are rarely symptomatic in children. Antral nodularity was associated with H. pylori infection; however, its absence does not preclude the diagnosis.

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