scholarly journals Evaluation and Management of Post-caustic Stenosis

10.37358/3700 ◽  
2019 ◽  
Vol 70 (10) ◽  
pp. 3700-3702
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Signs And Symptoms ◽  
Esophageal Stenosis ◽  
Caustic Ingestion ◽  
Upper Endoscopy ◽  
Endoscopic Dilation ◽  
Scoring Method ◽  
Caustic Stenosis

After caustic ingestion, patients may be either asymptomatic or may exhibit a variety of initial signs and symptoms, depending on the digestive segment predominantly affected. The DROOL system is a noninvasive scoring method used for the evaluation of esophageal lesions and has a good correlation with the development of esophageal stenosis. Management of these patients depends on several factors, including the presence of the symptomatology, in addition to the nature of the caustic substance. Upper endoscopy is indicated in the first 48 hours or after the first two weeks, when it is recommended to start endoscopic dilation sessions. If endoscopic treatment is inefficient, surgical treatment is required. Keywords: caustic ingestion, esophageal stenosis, esophageal bypass

scholarly journals Evaluation and Management of Post-caustic Stenosis

2019 ◽  
Vol 70 (10) ◽  
pp. 3700-3702
Author(s):  
Rodica Daniela Birla ◽  
Petre Angel Hoara ◽  
Valeriu Gabi Dinca ◽  
Silviu Constantinoiu
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Signs And Symptoms ◽  
Esophageal Stenosis ◽  
Caustic Ingestion ◽  
Upper Endoscopy ◽  
Endoscopic Dilation ◽  
Scoring Method ◽  
Caustic Stenosis

After caustic ingestion, patients may be either asymptomatic or may exhibit a variety of initial signs and symptoms, depending on the digestive segment predominantly affected. The DROOL system is a noninvasive scoring method used for the evaluation of esophageal lesions and has a good correlation with the development of esophageal stenosis. Management of these patients depends on several factors, including the presence of the symptomatology, in addition to the nature of the caustic substance. Upper endoscopy is indicated in the first 48 hours or after the first two weeks, when it is recommended to start endoscopic dilation sessions. If endoscopic treatment is inefficient, surgical treatment is required.

scholarly journals Esophageal caustic stenosis – difficulties of therapeutic management

2019 ◽  
Vol 6 (3) ◽  
pp. 90-95
Author(s):  
Andrei Crețu ◽  
Rodica Bîrlă ◽  
Petre Hoară ◽  
Alkadour Abdulah ◽  
Mădălina Mitrea ◽  
...  
Keyword(s):  
Life Support ◽  
Esophageal Stenosis ◽  
Oral Feeding ◽  
Middle Colic Artery ◽  
Endoscopic Dilation ◽  
Accidental Ingestion ◽  
Reconstruction Surgery ◽  
Esophageal Lumen ◽  
Caustic Injury ◽  
Caustic Stenosis

Esophageal stenosis is one of the most common sequels of caustic injury. After the ingestion, in the acute phase, the life support is sometimes critical, and the treatment varies from observation to esophagectomy. During the first 6 months, endoscopic dilation can be necessary in order to maintain the patency of the esophageal lumen. Usually, endoscopic dilation is the treatment of choice for caustic stenosis of the esophagus. Sometimes this procedure is not possible or too risky and then reconstruction surgery is needed, but no earlier than 6 months. We present the case of a 57 years old male who was referred to our clinic for the treatment of a mid-esophageal caustic stenosis, after the accidental ingestion of a concentrated alkaline substance 6 months before. After an initial successful endoscopic dilation, in the second attempt, due to the asymmetric position of the stenosis and the high risk of perforation, we decided to perform an esophageal by-pass. We chose to use the left colon for interposition, with the left branch of middle colic artery as the feeding source and the sigmoid trunk as the second arcade. The surgical procedure went uneventful, with restoration of normal oral feeding.

scholarly journals Vertical gastric plication versus Nissen fundoplication in the treatment of gastroesophageal reflux in children with cerebral palsy

2007 ◽  
Vol 125 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Antonio Paulo Durante ◽  
Sergio Tomaz Schettini ◽  
Djalma José Fagundes
Keyword(s):  
Cerebral Palsy ◽  
Surgical Treatment ◽  
Gastroesophageal Reflux ◽  
Nissen Fundoplication ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
High Morbidity ◽  
Gastric Plication ◽  
Esophageal Ph ◽  
Children With Cerebral Palsy

CONTEXT AND OBJECTIVE: Association between neurological lesions and gastroesophageal reflux disease (GERD) in children is very common. When surgical treatment is indicated, the consensus favors the fundoplication technique recommended by Nissen, despite its high morbidity and relapse rates. Vertical gastric plication is a procedure that may have advantages over Nissen fundoplication, since it is less aggressive and more adequately meets anatomical principles. The authors proposed to compare the results from the Nissen and vertical gastric plication techniques. DESIGN AND SETTING: Randomized prospective study within the Postgraduate Surgery and Experimentation Program of Unifesp-EPM, at Hospital do Servidor Público Estadual (IAMSPE) and Hospital Municipal Infantil Menino Jesus. METHODS: Fourteen consecutive children with cerebral palsy attended between November 2003 and July 2004 were randomized into two groups for surgical treatment of GERD: NF, Nissen fundoplication (n = 7); and VGP, vertical gastric plication (n = 7). These were clinically assessed by scoring for signs and symptoms, evaluation of esophageal pH measurements, duration of the operation, intra and postoperative complications, mortality and length of hospital stay. RESULTS: The mean follow-up was 5.2 months; symptoms were reduced by 42.8% (NF) (p = 0.001) and 57.1% (VGP) (p = 0.006). The Boix-Ochoa score was favorable for both groups: NF (p < 0.001) and VGP (p < 0.042). The overall mortality was 14.28% in both groups and was due to causes unrelated to the surgical treatment. CONCLUSION: The two operative procedures were shown to be efficient and efficacious for the treatment of GERD in neuropathic patients, over the study period.

scholarly journals Appendicitis in puerpeium: Case report

2011 ◽  
Vol 58 (4) ◽  
pp. 111-112 ◽  
Author(s):  
Milica Berisavac ◽  
Biljana Kastratovic-Kotlica ◽  
V. Tosic ◽  
N. Markovic ◽  
S. Ljustina ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Early Detection ◽  
Acute Appendicitis ◽  
Abdominal Wall ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Laboratory Infection ◽  
Infection Parameters ◽  
Clinical Signs And Symptoms

Acute appendicitis in puerperium is often diagnosed too late, because clinical signs can be unrelaible. Abdominal wall rigidity is rarely noticed in puerpeium because of weak abdominal wall muscles, laboratory parameters are not enough relaible and atipycal appendix presentation makes difficulties in diagnosis3,4. Knowing clinical signs and symptoms of appendicitis, possible complications and their early detection, make a chance for a good surgical outcome. Measuring of axillar and rectal temperature can take confusion in, and prolong time until surgical treatment. Leucocytosis in puerperium is not valid for diagnosis. We report a case of patient in puerperium with high laboratory infection parameters. Diagnosis of appendicitis is made based on clinical signs and symptoms, that is proved intraoperatively and histologicaly. Appendectomy without perforation carries less risks for mother and fetus.

Endoscopic Treatment of Benign Anastomotic Esophageal Stenosis with Electrocautery

Endoscopy ◽  
2002 ◽  
Vol 34 (5) ◽  
pp. 399-401 ◽  
Author(s):  
G. Brandimarte ◽  
A. Tursi
Keyword(s):  
Endoscopic Treatment ◽  
Esophageal Stenosis

scholarly journals Caustic Esophageal Stenosis: A Case Report of Endoscopic Dilation With a Dynamic Stent

2016 ◽  
Vol 23 (4) ◽  
pp. 218-223 ◽  
Author(s):  
Marlene Abreu ◽  
Isabel Nunes ◽  
Susana Corujeira ◽  
Marta Tavares ◽  
Eunice Trindade ◽  
...  
Keyword(s):  
Case Report ◽  
Esophageal Stenosis ◽  
Endoscopic Dilation

scholarly journals Unusual Presentation of Caustic Ingestion and its Surgical Treatment: A Case Report

2010 ◽  
Vol 10 (1) ◽  
pp. 74-76 ◽  
Author(s):  
Sunil Kumar Gupta ◽  
A. S. Rana ◽  
Deepak Gupta ◽  
Gaurav Jain ◽  
Puneet Kalra
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Unusual Presentation ◽  
Caustic Ingestion

Parosteal Osteogenic Sarcoma of the Mastoid Bone

1997 ◽  
Vol 106 (9) ◽  
pp. 729-732 ◽  
Author(s):  
Daniel R. Seely ◽  
George A. Gates
Keyword(s):  
Surgical Treatment ◽  
Osteogenic Sarcoma ◽  
Signs And Symptoms ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Long Bones ◽  
En Bloc ◽  
Radiographic Findings ◽  
Surrounding Soft Tissue ◽  
Mastoid Bone

Parosteal osteogenic sarcoma (POS) is an uncommon surface bone tumor, most often arising from the metaphyseal end of long bones. Involvement of the cranial bones is rare, with only 1 case of mastoid bone POS previously reported in the literature. Two patients with POS of the mastoid are presented, 1 followed up for 25 years after surgical treatment. The presenting signs and symptoms, as well as distinctive radiographic findings, are discussed. Histologic features are also described. Typically, cranial POS appears as a sessile, densely ossified surface growth with radiating bone spicules that blend with surrounding soft tissue. Treatment is en bloc resection, which is curative in most cases.

FA07.03: TRACHEO-BRONCHO-ESOPHAGEAL FISTULAE: THE NEW EPIDEMIC?

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 14-14
Author(s):  
Lucile Gust ◽  
Delphine Trousse ◽  
Geoffrey Brioude ◽  
Herve Dutau ◽  
Christophe Doddoli ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Conflicts Of Interest ◽  
Clinical Situation ◽  
Early Postoperative Period ◽  
The Other ◽  
Patient Death ◽  
Anastomotic Fistula ◽  
Post Radiation ◽  
Multimodal Management

Abstract Background Acquired Tracheo-broncho-esophageal fistulae of the adult are uncommon, severe and require a complex management associating medical, endoscopic and surgical treatment. Methods From January 2013 to December 2017, we conducted a monocentric, retrospective study on the etiology, the diagnosis and the management of acquired tracheo-broncho-esophageal fistulae. Results During the last 5 years, 29 consecutive acquired tracheo-broncho-esophageal fistulae were diagnosed in our department (23 men and 6 women), of which 2 malignant fistulae. Sixteen appeared in the early postoperative period after esophagectomy (From 7 to 63 days), and two more later at post-operative day 150 and 154 days. The other 10 tracheo-broncho-esophageal fistulae had variable etiologies: post-radiation (5), traumatic (4), severe reflux. Clinical presentation were of variable severity as well. Six patients were asymptomatic, the fistula diagnosed on systematic radiological or endoscopic examinations. The other patients had respiratory and infectious symptoms, going from iterative pneumopathy to acute respiratory distress with septic shock. The management was complex and specific to each patient, but 3 situations can be described: 1. Endoscopic treatment (7) 2. Surgical treatment, more or less followed by an endoscopic treatment (7) 3. Multiple endoscopic treatment, followed by surgery (13). Regardless of the treatment, the mortality rate was extremely high, 12 patients out of 27 dying in the early follow-up (44,4%). Conclusion The incidence of acquired tracheo-broncho-esophageal fistulae seems to be increasing, especially after esophagectomy. Their treatment is different than from the usual anastomotic fistula. Multimodal management is associated with patient death in about half of the cases. Endoscopic treatment allows the stabilisation of patients in a precarious clinical situation, but where the immediate results can be satisfactory it can later on lead to chronic and harmful situations. Surgery remains the cornerstone of the treatment. Disclosure All authors have declared no conflicts of interest.

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