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Esophageal Rupture

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1. Spontaneous Intramural Esophageal Rupture: An Uncommon Presentation of Eosinophilic Esophagitis Requiring Endoscopic Clipping Full Text available with Trip Pro

Spontaneous Intramural Esophageal Rupture: An Uncommon Presentation of Eosinophilic Esophagitis Requiring Endoscopic Clipping Spontaneous intramural esophageal rupture (SIER) is a form of acute esophageal trauma defined as an injury deeper than a Mallory-Weiss tear but not extending completely through the muscular propria as in Boerhaave syndrome. SIER is a rare complication of eosinophilic esophagitis (EoE); after extensive literature review, we found 7 case reports of SIER complicating EoE

2018 ACG case reports journal

2. Treatment of spontaneous esophageal rupture (Boerhaave syndrome) using thoracoscopic surgery and sivelestat sodium hydrate Full Text available with Trip Pro

Treatment of spontaneous esophageal rupture (Boerhaave syndrome) using thoracoscopic surgery and sivelestat sodium hydrate The mortality rate of spontaneous esophageal rupture remains 20% to 40% due to severe respiratory failure. We have performed thoracoscopic surgery for esophageal disease at our department since 1994. Sivelestat sodium hydrate reportedly improves the pulmonary outcome in the patients with acute lung injury (ALI).We retrospectively evaluated the usefulness of thoracoscopic (...) surgery and perioperative administration of sivelestat sodium hydrate for spontaneous esophageal rupture in 12 patients who underwent thoracoscopy at our department between 2002 and 2014.The patient cohort included 11 males and one female (median age, 61 years). The lower left esophageal wall was perforated in all patients. Surgical procedures consisted of thoracoscopic suture and thoracic drainage in six patients, transhiatal suture and thoracoscopic thoracic drainage in five, and thoracoscopic

2018 Journal of thoracic disease

3. Ductus Aneurysm Ruptured Into the Esophagus With Massive Bleeding. Full Text available with Trip Pro

Ductus Aneurysm Ruptured Into the Esophagus With Massive Bleeding. We report a patient with life-threatening hematemesis caused by the rupture of a ductus aneurysm into the esophagus, which was successfully treated by coil embolism for the esophageal fistula through the aorta and subsequent thoracic endovascular aortic replacement. Second-stage therapy was performed surgically after proactive antibiotic treatment and in consideration of the patient's improved general condition. This included (...) debridement with drainage, aortic encasement with remnant aneurysmal wall, omentopexy, and jejunostomy. The esophagus was preserved, and satisfactory healing and natural closure of the fistula were achieved. Although repeated aspirations were later required for pleural fluid, such inflammatory complications finally subsided.Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

2018 Annals of Thoracic Surgery

4. Endoscopic repair of spontaneous esophageal rupture during gastroscopy: A CARE compliant case report. Full Text available with Trip Pro

radiating into the back and upper abdomen. The diagnosis was made by computed tomography (CT) scan without delay. Enhanced CT showed extensive mediastinal emphysema, a small amount of left pleural effusion, and a 6 cm tear was confirmed in the lower esophagus posteriorly.The patient was diagnosed with an intrathoracic rupture type of spontaneous esophageal rupture.The patient received endoscopic suturing techniques under endotracheal intubation, titanium clip clamping, and over the scope clip (OTSC (...) Endoscopic repair of spontaneous esophageal rupture during gastroscopy: A CARE compliant case report. Most of esophageal rupture is a very serious life-threatening benign gastrointestinal tract disease with high mortality. However, there are a few cases of spontaneous esophageal rupture during gastroscopy.A 57-year-old man who underwent a routine diagnostic gastroscopy due to food obstruction was reported. During the gastroscopy, he vomited severely, which was followed by severe left chest pain

2018 Medicine

5. Two-tube method for treatment of spontaneous esophageal rupture and concomitant mediastinal infection Full Text available with Trip Pro

Two-tube method for treatment of spontaneous esophageal rupture and concomitant mediastinal infection Objective Spontaneous esophageal rupture (SER) is a rare but life-threatening condition with high mortality. The prognosis of patients with SER treated with surgical intervention or the traditional "three-tube" method is controversial. Thus, the aim of this study was to evaluate the clinical efficacy, feasibility, and safety of a new "two-tube" method involving a trans-fistula drainage tube (...) and a three-lumen jejunal feeding tube for the treatment of SER without concomitant pleural rupture. Methods From January 2007 to June 2016, patients with SER and managed with the "two-tube" method or other methods were retrospectively analyzed. Data collected included initial presentation, procedure time, duration of treatment, numbers of patients with eventual healing of leaks, and complications. Results The average procedure time for the "two-tube" method was 22.1 ± 5.5 minutes. In comparison

2018 The Journal of international medical research

6. Danis stent for acute oesophageal variceal bleeds

inflated). It comes preloaded in a balloon-style delivery system that is designed to allow accurate positioning at the gastro-oesophageal junction. The delivery system allows insertion of the stent into the lower oesophagus without radiological or endoscopic assistance. Radiopaque markers at the distal ends and midpoint of the stent allows its position to be confirmed by chest X- ray after the procedure. The Danis stent has retrieval loops with gold markers at both ends which allow the stent (...) inflated in the oesophagus, which may help minimise the risk of oesophageal perforation. It can stay in place for up to a week (compared with balloon tamponade, which should not be left in place for more than 24 to 36 hours). This may allow more time to plan definitive therapy or secondary prophylaxis before removal, as well as increasing the stabilisation period for improvement in liver function. The Danis stent lumen allows oral nutrition to be maintained, which is an important element in recovery

2019 National Institute for Health and Clinical Excellence - Advice

7. Development of quality indicators for endoscopic eradication therapies in Barrett?s esophagus: the TREAT-BE (Treatment with Resection and Endoscopic Ablation Techniques for Barrett?s Esophagus) Consortium

dysplasia: a randomized clinical trial. JAMA 2014;311: 1209-17. 15. Wolf WA, Pasricha S, Cotton C, et al. Incidence of esophageal adeno- carcinoma and causes of mortality after radiofrequency ablation of Barrett’s esophagus. Gastroenterology 2015;149:1752-61.e1. 16. Pech O, Behrens A, May A, et al. Long-term results and risk fac- tor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus. Gut (...) of Barrett’s esophagus. Gastro- enterology 2011;140:1084-91. 24. Fitzgerald RC, di Pietro M, Ragunath K, et al. British Society of Gastro- enterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut 2014;63:7-42. 25. Bennett C, Vakil N, Bergman J, et al. Consensus statements for man- agement of Barrett’s dysplasia and early-stage esophageal adenocar- cinoma, based on a Delphi process. Gastroenterology 2012;143: 336-46. 26. Abrams JA, Kapel RC, Lindberg GM, et al. Adherence to biopsy

2017 American Society for Gastrointestinal Endoscopy

8. Successful primary repair of late diagnosed spontaneous esophageal rupture: A case report Full Text available with Trip Pro

Successful primary repair of late diagnosed spontaneous esophageal rupture: A case report Spontaneous esophageal rupture is rare, roughly 300 cases reported annually. Diagnosis is often delayed or missed. Overall mortality is about 20%. This feared high mortality rate has led to the misconception that primary esophageal repair should be avoided in late diagnosed patients. We report a successful primary repair of spontaneous esophageal rupture which was delayed for more than two weeks.A 53 year (...) -old male presented to our medical service after falsely having been treated for pneumonia at an outside hospital. He was subsequently diagnosed with spontaneous esophageal rupture and treated with over the scope clips followed by stenting. Persistent leak into mediastinum made surgical exploration necessary. At exploration a primary repair could be performed successfully.Unsuccessful endoscopic management of esophageal perforation that was delayed for two weeks underwent primary surgical repair

2017 International journal of surgery case reports

9. Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy Full Text available with Trip Pro

RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury. We performed a jejunal free flap repair of the 8-cm defect in the esophagus. End-to-side microvascular anastomoses were created between the right external carotid artery and the jejunal branches of the superior mesenteric artery, and end-to-end anastomosis was performed between the external jugular vein (...) Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following

2017 Archives of plastic surgery

10. Hepatic and Gastric Involvement in a Case of Systemic Sarcoidosis Presenting with Rupture of Esophageal Varices Full Text available with Trip Pro

Hepatic and Gastric Involvement in a Case of Systemic Sarcoidosis Presenting with Rupture of Esophageal Varices A 46-year-old woman presented with massive hematemesis, caused by the rupture of esophageal varices. The laboratory investigations showed pancytopenia, and imaging tests revealed hepatosplenomegaly and ascites. A diagnosis of systemic sarcoidosis was made based on biopsies of the liver, stomach, lungs, heart, and skin. Although fat deposition was predominant, non-caseating granuloma

2017 Internal Medicine

11. Endoscopic clipping of spontaneous esophageal rupture: Case reports of three patients Full Text available with Trip Pro

Endoscopic clipping of spontaneous esophageal rupture: Case reports of three patients Spontaneous esophageal rupture is a life-threatening condition which is difficult to diagnose early, and is usually treated surgically. Prolonged hospitalization is common. Non-operative treatment of esophageal rupture localized to the mediastinum has been reported. We report three patients with spontaneous esophageal rupture successfully managed with endoscopic clipping.Two patients had ruptures localized

2017 International journal of surgery case reports

12. Hydropneumothorax Due to Esophageal Rupture. (Abstract)

computed tomography (CT) scan demonstrated overt leakage of oral contrast into the right pleural space. She was treated with ongoing pleural evacuation, antibiotics, antifungals, and total parenteral nutrition. The patient and family declined surgical resection as well as endoscopic stent placement. In 1724, Boerhaave described spontaneous rupture of the esophagus postmortem; Boerhaave syndrome remains the name for complete disruption of the esophageal wall in the absence of pre-existing pathology (...) typically occurring after vomiting. It most commonly occurs in the distal left posterolateral thoracic esophagus. Contrast esophagram is considered the "gold standard" for diagnosing esophageal rupture although CT esophagography also shows good diagnostic performance. Treatment includes nil per os status, broad-spectrum antibiotics, and drainage of the pleural space. Surgical repair of the esophageal perforation should be done early if the patient is deemed a good candidate, and esophageal stenting

2017 Journal of Emergency Medicine

13. Esophageal Rupture

, Oesophageal rupture , Esophageal rupture , Bursting injury of esophagus , Bursting injury of oesophagus , Disruption of esophagus , Disruption of oesophagus , Rupture of oesophagus , Rupture of esophagus (disorder) , esophagus; rupture , rupture; esophagus , Rupture of esophagus Hungarian Oesophagealis szakadás , Oesophagus ruptura Dutch oesofagus; ruptuur , ruptuur; oesofagus , slokdarmruptuur German Speiseroehrenriss Derived from the NIH UMLS ( ) Related Topics in Esophageal Disorders About (...) PERFORATION , esophageal perforation , esophageal perforation (diagnosis) , Esophageal perforation , Perforation esophagus , Oesophageal perforation , Perforation Of Esophagus , Esophageal Perforation [Disease/Finding] , esophagus perforation , perforation esophagus , oesophageal perforation , perforation of esophagus , Perforation of oesophagus (disorder) , Perforation oesophagus , PERFORATION OF ESOPHAGUS , Perforation of Esophagus , ESOPHAGUS, PERFORATION OF , Perforation of esophagus , Perforation

2018 FP Notebook

14. Budesonide (Jorveza) - to treat adults with eosinophilic oesophagitis

above, the disease leads to a considerably reduced Quality of Life, and – along with remodelling of the oesophagus – to the development of oesophageal strictures, and the subsequent need for dilation manoeuvers. Rarely, complications such as oesophageal perforation and rupture of the oesophagus from forceful retching (Boerhave’s syndrome) have been observed. EoE has not been observed to be associated with the development of cancer and does not reduce life expectancy. 2.1.5. Management The current (...) ) and complications, such as food impaction. This is different from children, where a variety of nonspecific symptoms, such as feeding difficulty, nausea and vomiting, heartburn, and failure to thrive are observed. The final diagnosis of EoE is, however, only made after upper GI endoscopy, including biopsy of the oesophageal mucosa, the diagnosis of eosinophil infiltration of the oesophagus, and the exclusion of other disease entities, such as GERD, Achalasia, Coeliac disease, Crohn’s Disease, and several

2018 European Medicines Agency - EPARs

15. Recurrent Spontaneous Esophageal Rupture Managed With Esophageal Stenting. Full Text available with Trip Pro

Recurrent Spontaneous Esophageal Rupture Managed With Esophageal Stenting. Recurrent spontaneous esophageal ruptures are rare, found in only a few case reports. They are treated mostly by thoracotomy and repair, but none through stenting alone. We present a patient with recurrent spontaneous esophageal rupture who was successfully treated through stenting and made a speedy and complete recovery. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

2016 Annals of Thoracic Surgery

16. Oesophageal varices

/12085369?tool=bestpractice.com Once cirrhosis has developed, increasing hepatic vein pressure gradient and deteriorating liver function may result in the formation of oesophageal varices, which may grow up to a critical point, when they rupture and cause life-threatening bleeding. The most important predictor of variceal haemorrhage is the size of varices, with the highest risk of first haemorrhage occurring in patients with large varices (15% per year). North Italian Endoscopic Club for the Study (...) Oesophageal varices Oesophageal varices - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Oesophageal varices Last reviewed: February 2019 Last updated: January 2017 Summary A direct consequence of portal HTN as a progressive complication of cirrhosis. The development of bleeding carries significant morbidity and mortality. Non-selective beta-blockers and/or endoscopic ligation can prevent the development of variceal

2017 BMJ Best Practice

17. Sirens to Scrubs: Esophageal Foreign Body Obstructions

. Triadafilopoulos G. Boerhaave Syndrome: Effort Rupture of the Esophagus. UpToDate. . Published February 21, 2018. Accessed August 5, 2018. 4. Muntor D. Esophageal Foreign Bodies. In: Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care . 7th ed. Elsevier; 2018:1500. 5. ASGE S, Ikenberry S, Jue T, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc . 2011;73(6):1085-1091. [ ] (Visited 832 times, 3 visits today) Paula Sneath Paula is a PGY1 in Emergency (...) body obstruction (FBO)? How can emergency providers manage esophageal FBOs, both in the field and in the ED? What are signs of life-threatening injuries of an esophageal foreign body obstruction? Our steak-eater is suffering from a “café coronary” where the meat bolus has gotten stuck in the proximal esophagus and occluded the posterior trachea, which can ultimately lead to loss of vital signs. In this situation, a history will often suggest the pathology. In the case of a complete, or near

2018 CandiEM

18. CRACKCast E089 – Esophagus, Stomach & Duodenum

to section: throat-esophagus and then stomach. 1) List the the types of dysphagia. What is an ED approach to this condition? Swallowing is divided into oral, pharyngeal, and esophageal phases. Failure at any one of these levels results in dysphagia, which literally means “difficulty Swallowing.” When it comes to causes, just think M&M. The problem is either a mechanical block or a motility problem. The upper swallowing action is very complex neuro-muscular action that involves the lips, tongue, pharynx (...) – thyrotoxicosis, lead poisoning, Mg deficiency Obstructive Dysphagia lusoria 3) List 6 causes of esophageal dysphagia. “Delayed / gets stuck” Again think M&M Mechanical Intrinsic issue: strictures, webs, rings, tumours, EsophagitIs, ***foreign bodies*** Extrinsic compression: osteopHytes, ***mediastinal masses***, aortic aneurysm, thyroid goitre Motility Intrinsic: Achalasia, diffuse esophageal spasm, hypertensive LES, scleroderma, CREST syndrome, nutcracker esophagus Extrinsic: Gastric volvulus Alcoholism

2017 CandiEM

19. Esophageal Rupture After Ghost Pepper Ingestion. (Abstract)

Esophageal Rupture After Ghost Pepper Ingestion. The ghost pepper, or "bhut jolokia," is one of the hottest chili peppers in the world. Ghost peppers have a measured "heat" of > 1,000,000 Scoville heat units (SHU), more than twice the strength of a habanero pepper. To our knowledge, no significant adverse effects of ghost pepper ingestion have been reported.A 47-year-old man presented to the Emergency Department (ED) with severe abdominal and chest pain subsequent to violent retching (...) and vomiting after eating ghost peppers as part of a contest. A subsequent chest x-ray study showed evidence of a left-sided pleural effusion and patchy infiltrates. A computed tomography scan of the abdomen and pelvis showed pneumomediastinum with air around the distal esophagus, suggestive of a spontaneous esophageal perforation and a left-sided pneumothorax. The patient was intubated and taken immediately to the operating room, where he was noted to have a 2.5-cm tear in the distal esophagus

2016 Journal of Emergency Medicine

20. Factors Associated with Bleeding Secondary to Rupture of Esophageal Varices in Children and Adolescents With Cirrhosis. (Abstract)

Factors Associated with Bleeding Secondary to Rupture of Esophageal Varices in Children and Adolescents With Cirrhosis. Bleeding of esophageal varices is the main cause of morbidity and mortality in children with portal hypertension. It is important to understand the factors related with a bleeding episode to evaluate more effective primary prophylaxis. The present study aims to describe the endoscopic and laboratory findings associated with upper gastrointestinal bleeding (UGIB) secondary (...) presence of gastric varices and red spots on esophageal varices were related to episodes of UGIB secondary to rupture of esophageal varices. When these findings are observed, indications for endoscopic primary prophylaxis should be evaluated. More studies are, however, necessary to better understand this problem.

2016 Journal of Pediatric Gastroenterology and Nutrition

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