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Esophageal Rupture

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241. Eso-Sponge Registry

Summary: This international, prospective and multicenter registry was designed to collect clinical evidence for the endoscopic vacuum treatment using Eso-SPONGE® for anastomotic leakage after esophageal resection or iatrogenic or spontaneous esophageal perforation. Condition or disease Intervention/treatment Leakage After Esophagectomy Leakage After Gastrectomy Perforation of the Esophagus Device: Eso-SPONGE® vacuum treatment Detailed Description: Anastomotic Leakages or other defects in the upper (...) . The overall success rate of endoscopic esophageal vacuum therapy in the literature ranges from 80-100%. Currently only cohort studies including a small number of patients have been performed and published. Therefore an international, prospective and multicenter registry was designed to collect clinical evidence for Eso-SPONGE treatment concept in a large population under daily clinical routine. Study Design Go to Layout table for study information Study Type : Observational [Patient Registry] Estimated

2016 Clinical Trials

242. Evaluation of Impact of Nitrous Oxide on PONV in Breast Surgeries

Hospital Study Details Study Description Go to Brief Summary: Postoperative nausea and vomiting (PONV) is considered one of the most unpleasant postoperative discomforts and lead to serious complications of aspiration of gastric contents, suture dehiscence, esophageal rupture, subcutaneous emphysema, or pneumothorax. The incidence of PONV is 30-40% in normal population and touches a peak of 75-80% in certain high-risk groups. PONV is associated with delayed recovery and prolonged hospital stay

2016 Clinical Trials

243. Perioperative Endothelial Dysfunction in Patients Undergoing Major Acute Abdominal Surgery

to a non-elective procedure on the GI tract Cholecystectomy +/- drainage of localized collection unless the procedure is incidental to a non-elective procedure on the GI tract (All surgery involving the appendix or gallbladder, including any surgery relating to complications such as abscess or bile leak is excluded) Non-elective hernia repair without bowel resection. Minor abdominal wound dehiscence unless this causes bowel complications requiring resection Ruptured ectopic pregnancy, or pelvic (...) abscesses due to pelvic inflammatory disease Laparotomy/laparoscopy for pathology caused by blunt or penetrating trauma Laparotomy/laparoscopy for esophageal pathology Laparotomy/laparoscopy for pathology of the spleen, renal tract, kidneys, liver, gall bladder and biliary tree, pancreas or urinary tract Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information

2016 Clinical Trials

244. Efficacity and Safety of Tranexamic Acid in Cirrhotic Patients Presenting With Acute Upper Gastrointestinal Bleeding

leading cause is the rupture of gastro-esophageal varices due to portal hypertension. In cirrhotic patients, the management of acute gastrointestinal haemorrhage is challenging as they often present with coagulation (or haemostasis abnormalities) abnormalities such as hyperfibrinolysis, especially when the cirrhosis is decompensated. Beyond life support measures, therapeutic modalities of upper gastrointestinal bleeding rely on both endoscopic and pharmacological interventions. Tranexamic acid (TA (...) relapses and one-year mortality. Condition or disease Intervention/treatment Phase Upper Digestive Bleeding Cirrhosis Drug: Tranexamic acid Drug: Placebo Phase 4 Detailed Description: Acute Upper gastrointestinal haemorrhage (UGIH) is frequent, with an estimated annual incidence of 150/100 000 in France. Its second etiology is the rupture of portal hypertension-related gastro-esophageal varices, accounting for 20 % of the patients and responsible for more than 50 % of the hospitalizations in intensive

2016 Clinical Trials

245. Sorafenib Combined With Aspirin to Prevent the Recurrence in High-risk Patients With Hepatocellular Carcinoma

,Tumor margin is not clear and no complete capsule. With the embolus in Portal vein, hepatic vein or bile duct. Preoperative rupture or invasion the adjacent organs. The positive cut edge. Residual lesions showed by Postoperative digital subtraction angiography(DSA). Alpha fetoprotein(AFP) did not drop to normal range two months after surgery. The characteristics of the patients: The patient age was between 18-75. The American Society of Anesthesiologists(ASA)score was I-III. No history of esophageal

2016 Clinical Trials

246. Pharmacological Reduction of Functional, Ischemic Mitral REgurgitation

: History of hypersensitivity or allergy to the study drug, drugs of similar chemical classes, ARBs, or NEP inhibitors as well as known or suspected contraindications to the study drug Known history of angioedema Any evidence of structural mitral valve disease, including prolapse of mitral leaflets and rupture of chords or papillary muscles Current acute decompensated heart failure or dyspnea of NYHA functional class IV Medical history of hospitalization within 6 weeks Symptomatic hypotension (...) and/or a SBP < 100 mmHg at screening Estimated GFR < 30 mL/min/1.73m2 Serum potassium > 5 mmol/L at screening Evidence of hepatic disease as determined by any one of the following: AST or ALT values exceeding 2 x upper limit of normal (ULN) at screening visit (Visit 0), history of hepatic encephalopathy, history of esophageal varices, or history of portacaval shunt Acute coronary syndrome, stroke, major CV surgery, PCI within 3 months Planned coronary revascularization or mitral valve intervention within 1

2016 Clinical Trials

247. Family Practice Notebook Updates 2017

in early pregnancy Newborn (neonatal abstinence syndrome) if maternal use No evidence of safety (gi, esophagus) Immune mediated esophagitis ( of the esophagus) that does not respond to management May present with solid , food impaction, anterior , and refractory Strongly associated with allergic conditions If management ineffective, try activating steroid MDI (e.g. HFA) and swallowing, not inhaling IV. Updates: October 2017 (geri, prevent) Approach falls as a sentinel event, a predictor of future falls (...) for monitoring coma (lung, rad) Single view per side (at 3rd interspace) has equivalent for as 4 view (CV, EKG) In PEA, when PE is strongly suspected, TPA 50 mg IV given in the first ~6 min of CPR, resulted in 85% longterm survival (gi, esophagus) Reviewed technique for extraction of esophageal coins (and other flat, blunt, small objects) (CV, CHF) control is paramount ( s, s, s) Limit to when is present (otherwise risk of decreased and increased symptoms) (gi, liver) reactivation is a risk when treating

2018 FP Notebook

248. Long-Term Outcome of 154 Patients Receiving Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Fundal Varices. (PubMed)

exacerbation rates of esophageal varices at 1, 3, and 5 years were 13%, 20%, and 27%, respectively, and rupture developed in six patients, which were successfully treated with endoscopic therapies.Therapeutic strategies including B-RTO with a microballoon catheter were useful to achieve a favorable outcome in patients with gastric fundal varices especially in those manifesting Child-Pugh class-A liver damage and/or those without hepatocellular carcinoma complication.© 2016 Journal of Gastroenterology (...) tamponade was performed to achieve hemostasis. B-RTO was accomplished with injection of 5% ethanolamine oleate through a standard balloon catheter except for patients with atypical varices, in whom a microballoon catheter was used to occlude drainage vessels other than a gastrorenal shunt. In patients complicated with esophageal varices at baseline, endoscopic therapies were performed following B-RTO.Balloon-occluded retrograde transvenous obliteration was performed successfully in 147 patients (95

2016 Journal of gastroenterology and hepatology

249. Thoracic Actinomycosis: A Rare Occurrence (PubMed)

of a previously inserted esophageal stent for an unsuccessful surgical repair of an esophageal rupture. In addition to the contrast leakage, the presence of a bronchopulmonary fistula imaging prompted the need for further investigation. Our patient was empirically treated with antibiotics and obtained blood cultures, which returned positive A. israelii.

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2016 Infectious disease reports

250. Boerhaave's syndrome (PubMed)

Forces Medical College, Pune 411040, India. Bhatia Mukul M Associate Professor, Department of Radiodiagnosis, Armed Forces Medical College, Pune 411040, India. eng Case Reports 2016 02 23 India Med J Armed Forces India 7602492 0377-1237 Boerhaave's syndrome Esophageal perforation Esophageal rupture 2015 08 17 2015 12 10 2017 1 5 6 0 2017 1 5 6 0 2017 1 5 6 1 ppublish 28050085 10.1016/j.mjafi.2015.12.004 S0377-1237(15)00201-4 PMC5192176 Chest Surg Clin N Am. 1994 Nov;4(4):819-25 7859012 Am Surg. 1992

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2016 Medical journal, Armed Forces India

251. Nasogastric Tube

Esophagitis or Esophageal reflux Rupture of X. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Nasogastric Tube." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Nasogastric tube (C0085678) Definition (UMD) Tubes designed to access the stomach through the nose, nasopharynx, and esophagus for examination, treatment, or other purposes (...) ) Increased secretions and need for suctioning Increased need for repositioning Clogged or kinked Secondary mechanical obstruction from (pylorus obstruction or ) Nasopharyngeal Nasopharyngeal erosions Trachea, and lung Post-cricoid perichondritis Misdirected tube into airway (with risk of infusion directly into lung) Tracheoesophageal fistula Gastric aspiration with secondary pneumonitis Tracheobronchial perforation Airway obstruction Esophagus Esophageal bleeding Esophageal or duodenal perforation

2018 FP Notebook

252. Obesity Surgery

complications See specific complications below High risk presentations (red flag) (red flag) or Bleeding with Approach Involve bariatric surgeon early in presentation to discuss evaluation and management strategy (often indicated, but beware false negatives) When performing , consider CT chest for given similar presentations caution with oral due to small proximal pouch Avoid harmful measures Avoid s, , and other irritative agents Avoid Risk of proximal pouch rupture Ineffective at decompression after most (...) M&M size or smaller Avoid enteric coated, delayed-release or sustained release products s is preferred Avoid s due to peptic ulcer risk (or if absolutely unavoidable, combine with ) Medications requiring dose modification (or elimination) as weight loss occurs Antihypertensives s (e.g. s) Diabetes Medications Avoid agents associated with (e.g. s) (increased risk after Bariatric Surgery) Obtain 2 years after surgery Avoid oral due to esophageal ulcer risk (at least in short term following

2018 FP Notebook

253. Pneumomediastinum

: Pneumomediastinum From Related Chapters II. Pathophysiology Spontaneous rupture of alveolus or bleb Results from increased pressure gradient Negative (Inhalation) Positive (Valsalva) Air tracks along vessels and Air coalesces in mediastinum III. Causes (e.g. ) ing Weight lifting Parturition IV. Symptoms Worse with lying Better with sitting V. Signs Subcutaneous (50%) VI. Differential Diagnosis Tension Pneumomediastinum VII. Radiology: Chest XRay As many as 50% Pneumomediastinum cases missed on PA Review Lateral (...) or other situations that lead to air escaping from the lungs, airways or bowel into the chest cavity. Definition (NCI) The presence of air in the mediastinum. It is caused by injury, most often esophageal or intestinal perforation. Definition (MSH) Presence of air in the mediastinal tissues due to leakage of air from the tracheobronchial tree, usually as a result of trauma. Concepts Pathologic Function ( T046 ) MSH ICD10 SnomedCT 155627006 , 390899006 , 196144009 , 266411000 , 16838000 English

2018 FP Notebook

254. Autosomal Dominant Polycystic Kidney Disease

) ADPKD1 gene on short arm of 16 PKD1 encodes integral membrane protein Polycystin-1 End-stage renal disease average age of onset: 57 Associated with a higher risk of progression to end-stage renal disease than for the PKD2 gene mutation PKD2 : (14% of cases) ADPKD2 gene on 4 PKD2 encodes integral membrane protein Polycystin-2 End-stage renal disease average age of onset: 69 V. Symptoms Symptom onset is delayed until patients are in their 30-40s Flank or (60%) causes rupture Enlarged compression (...) years (males): 6 or more cysts in each s Age 45 to 59 years (females): 9 or more cysts in each s References X. Complications (at least 45% of cases) Accounts for 5-10% of ( ) By age 70 years old, 80% have end-stage renal disease or have died of other cause Children: 30% Adults: 60% : 80% Extra- s Extra- s most commonly occur in the liver (34-78%) s also occur in the ovaries, s, , and central nervous system (26%) (due to aortic root dilitation) (associated with rupture) (20%) (5-10%) At least twice

2018 FP Notebook

255. Family Practice Notebook Updates 2017

in early pregnancy Newborn (neonatal abstinence syndrome) if maternal use No evidence of safety (gi, esophagus) Immune mediated esophagitis ( of the esophagus) that does not respond to management May present with solid , food impaction, anterior , and refractory Strongly associated with allergic conditions If management ineffective, try activating steroid MDI (e.g. HFA) and swallowing, not inhaling IV. Updates: October 2017 (geri, prevent) Approach falls as a sentinel event, a predictor of future falls (...) for monitoring coma (lung, rad) Single view per side (at 3rd interspace) has equivalent for as 4 view (CV, EKG) In PEA, when PE is strongly suspected, TPA 50 mg IV given in the first ~6 min of CPR, resulted in 85% longterm survival (gi, esophagus) Reviewed technique for extraction of esophageal coins (and other flat, blunt, small objects) (CV, CHF) control is paramount ( s, s, s) Limit to when is present (otherwise risk of decreased and increased symptoms) (gi, liver) reactivation is a risk when treating

2018 FP Notebook

256. Aortic Dissection

to (TEE) or MRA : 100% with new generation CT (older studies quoted 94%) : 98% with new generation CT (older studies quoted 90%) : 97% : 75-90% MRA Not recommended as an emergency evaluation (may be indicated in some stable patients) : 98% : 98% : 90% : Low (non-diagnostic) Unlikely to demonstrate anything more than intrathoracic catastrophe (progressive), aortic knob widening Tracheal, al or esophageal deviation XIII. Complications Neurologic deficits Unequal perfusion Unequal pulses Unequal (...) extremity s (with ) Aortic valve rupture XIV. Management Lower (in addition to lowering) Goals (confirm goal levels with accepting vascular surgeon) goal: <120 mmHg (based on consensus expert opinion) goal: <60 bpm (based on consensus expert opinion) First-Line Agents Clevidipine 20-40 mg incremental boluses IV Consider while awaiting CT imaging and diagnosis Adjunctive measures Decreasing pain will decrease Older agents that have largely been replaced 0.5-10 ug/kg/min IV Trimethaphan 1-4 mg/min IV

2018 FP Notebook

257. Transesophageal Ultrasonography

and not interfere with efforts Heart function and compression quality can be accurately monitored Distinguishes cardiac standstill (true PEA or ) from ineffective contraction May identify , PE with RV strain, vascular rupture III. Contraindications Severe esophageal stenosis Tracheoesophageal fistula More common in gastrostomy IV. Technique: Scope Assumes or TEE is inserted and steered in similar fashion to bronchoscope, or endoscope Multiplane transducer lies in the scopes flat head Transducer direction (...) is manipulated with thumb pad on scope handle Examiner hand positions Examiner holds scope with non-dominant hand by patients mouth to insert, secure or withdraw the tube Examiner uses dominant hand to hold the scope handle and manipulate the transducer direction Key Views (see below) Mid-Esophageal Four-Chamber View (MEFC View) Transgastric Mid-Papillary Short-Axis View (TGMPSA) V. Imaging: Mid-Esophageal Four-Chamber View (MEFC View) Positioning Visualized on initial probe insertion Multiplane transducer

2018 FP Notebook

258. Study to Assess the Effect of the Aerobika Device in Addition to Standard of Care Treatment in Sputum Producing COPD Patients Using FRI

with recent facial, oral, or skull surgery or trauma. Subject with active acute sinusitis. Subject with active epistaxis (i.e. bleeding nose). Subject with a history of esophageal surgery. Subject with an active diagnosis of nausea on Visit 1. Subject with active hemoptysis (i.e. bleeding from lungs). Subject with untreated pneumothorax (i.e. untreated collapsed lung). Subject with known or suspected tympanic membrane rupture or other middle ear pathology. Subject unable to perform pulmonary function

2016 Clinical Trials

259. EUS-guided Fine Needle Aspiration (EUS-FNA) Versus EUS-guided Fine Needle Biopsy (EUS-FNB) for Diagnosis of Subepithelial Tumors

Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Esophageal, gastric, or duodenal SET over 2 cm Hypoechoic lesion including 4th layer on EUS Exclusion Criteria: SET with characteristic findings such as lipoma, vessels, or ectopic pancreas bleeding or rupture of SET platelet count <50,000 or prothrombin time INR > 1.3 Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you

2016 Clinical Trials

260. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. (PubMed)

and small objects (except batteries and magnets). If feasible, outpatient management is appropriate (strong recommendation, low quality evidence). 6 ESGE recommends close observation in asymptomatic individuals who have concealed packets of drugs by swallowing ("body packing"). We recommend against endoscopic retrieval. We recommend surgical referral in cases of suspected packet rupture, failure of packets to progress, or intestinal obstruction (strong recommendation, low quality evidence). Endoscopic (...) measures 7 ESGE recommends emergent (preferably within 2 hours, but at the latest within 6 hours) therapeutic esophagogastroduodenoscopy for foreign bodies inducing complete esophageal obstruction, and for sharp-pointed objects or batteries in the esophagus. We recommend urgent (within 24 hours) therapeutic esophagogastroduodenoscopy for other esophageal foreign bodies without complete obstruction (strong recommendation, low quality evidence). 8 ESGE suggests treatment of food bolus impaction

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2016 Endoscopy

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