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Esophageal Rupture

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61. Emergency endoscopic variceal ligation following variceal rupture in patients with advanced hepatocellular carcinoma and portal vein tumor thrombosis: a retrospective study Full Text available with Trip Pro

Emergency endoscopic variceal ligation following variceal rupture in patients with advanced hepatocellular carcinoma and portal vein tumor thrombosis: a retrospective study The outcomes of treatment of ruptured varices in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) are unclear. We therefore evaluated the long- (rebleeding and death) and short-term (immediate death within 24 h of variceal bleeding diagnosis) outcomes of patients with PVTT who underwent (...) emergency variceal band ligation.Data on 62 patients with PVTT and endoscopically proven esophageal or gastric variceal bleeding from 2007 to 2012 were studied. In most cases, the varices were treated using endoscopic variceal band ligation (EVL). We assessed the patients' rebleeding-free and overall survival using the Kaplan-Meier method, and a Cox proportional hazard model was used to analyze effect of independent factors on rebleeding-free and overall survival times.Most patients had decompensated

2016 World journal of surgical oncology

62. Predictive Factors and Outcome of Esophageal Ulcers After Endoscopic Treatment of Esophageal Varices

to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). Endoscopic therapy is a local treatment that has no effect on the pathophysiological mechanisms that lead to portal hypertension and variceal rupture. However, a spontaneous decrease in HVPG occurs in around 30% of patients treated with either EST or EBL to prevent variceal rebleeding. Device: Esophagogastroduodenoscope (...) Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). Endoscopic therapy is a local treatment that has no effect on the pathophysiological mechanisms that lead to portal hypertension and variceal rupture. However, a spontaneous decrease in HVPG occurs in around 30% of patients treated with either EST or EBL to prevent variceal rebleeding

2014 Clinical Trials

63. Guidelines for the Surgical Treatment of Esophageal Achalasia

Guidelines for the Surgical Treatment of Esophageal Achalasia Guidelines for the Surgical Treatment of Esophageal Achalasia - A SAGES Publication Society of American Gastrointestinal and Endoscopic Surgeons Guidelines for the Surgical Treatment of Esophageal Achalasia This document was reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in May 2011. Dimitrios Stefanidis, MD, PhD, FACS, FASMBS, William Richardson, MD (...) , Pittsfield, MA, USA Corresponding Author: Dimitrios Stefanidis, MD, PhD, FACS, FASMBS Associate Professor of Surgery Vice Chair of Education Director of MIS/Bariatric Surgery IU Deparment of Surgery Skills Lab Director 545 Barnhill Dr Emerson Hall Indianapolis, IN 46202 Tel: (317) 688-5038 Preamble The guidelines for the surgical treatment of esophageal achalasia are a series of systematically developed statements to assist surgeon (and patient) decisions about the appropriate use of minimally invasive

2011 Society of American Gastrointestinal and Endoscopic Surgeons

64. Life-Threatening Retropharyngeal Hemorrhage Secondary to Rupture of the Inferior Thyroid Artery Full Text available with Trip Pro

was deviated anteriorly and there was esophageal compression. An emergent arteriogram and catheterization confirmed bleeding from branches of the ITA, and successful embolization was performed. It is important to recognize the ITA rupture as a potential etiology of an acute airway compromise. In emergent situations, while securing an airway is a priority, rapidly initiating diagnostic testing to confirm the diagnosis and arranging for arterial embolization can be life-saving. (...) Life-Threatening Retropharyngeal Hemorrhage Secondary to Rupture of the Inferior Thyroid Artery Inferior thyroid artery (ITA) rupture is rare and may progress to life-threatening conditions. We present a patient who visited the emergency department after an episode of syncope and dizziness in which he had a mechanical fall that resulted in abrasions and a hematoma to his left forehead. The patient presented with dysphagia and anterior neck swelling that progressed rapidly into airway compromise

2015 Case Reports in Emergency Medicine

65. Thoracoscopic esophageal repair with barbed suture material in a case of Boerhaave’s syndrome Full Text available with Trip Pro

Thoracoscopic esophageal repair with barbed suture material in a case of Boerhaave’s syndrome A 53-year-old man was referred to our hospital with Boerhaave's syndrome. Thirty hours after onset, a left thoracoscopic operation was performed, with carbon dioxide pneumothorax and the patient in right semi-prone position. The thoracic cavity was copiously irrigated with physiological saline and a 4-cm longitudinal rupture was identified on the left side of the lower esophagus. The esophageal (...) injury was repaired in 2 layers by using barbed absorbable suture material. The patient was allowed oral feeds after contrast esophagography confirmed the absence of contrast leak at the sutured site on postoperative day 7, and discharged by day 28. Suturing of the ruptured esophagus under thoracoscopic guidance is considered to be difficult and requires expertise. This case report demonstrates that the use of a barbed suture material simplifies thoracoscopic esophageal repair and also highlights

2016 Journal of thoracic disease

66. Aortic Pseudoaneurysm Secondary to Mediastinitis due to Esophageal Perforation Full Text available with Trip Pro

Aortic Pseudoaneurysm Secondary to Mediastinitis due to Esophageal Perforation Esophageal perforation is a condition associated with high morbidity and mortality rates; it requires early diagnosis and treatment. The most common complication of esophageal rupture is mediastinitis. There are several case reports in the literature of mediastinitis secondary to esophageal perforation and development of aortic pseudoaneurysm as a complication. We report the case of a patient with an 8-day history (...) of esophageal perforation due to foreign body (fishbone) with mediastinitis and aortic pseudoaneurysm. The diagnosis was made using Computed Tomography (CT) with intravenous and oral water-soluble contrast material. An esophagogastroduodenoscopy did not detect the perforation.

2016 Case Reports in Radiology

67. A novel biodegradable esophageal stent: results from mechanical and animal experiments Full Text available with Trip Pro

A novel biodegradable esophageal stent: results from mechanical and animal experiments Biodegradable esophageal stents eliminate stent retrieval, but usually induce hyperplasia. This study investigated the properties of a novel biodegradable stent in vitro and in vivo. The degradation of the novel stent was observed in phosphate buffered saline (PBS) for 8 weeks. The radial forces, pH values, morphology, and retention rate of the intrinsic viscosity (R[η]) of the new biodegradable stent were (...) all evaluated. In vitro, the pH values remained constant for 4 weeks and declined from weeks 4 to 8. The biodegradable threads degraded and ruptured at 6 weeks. Consequently, the radial force of the stent decreased to zero at that time. The curve of R[η] decreased with time linearly in PBS. To study the stents in vivo, we used a stricture model in which the middle esophagus of rabbits was damaged by alkali burn. Stents were inserted 2 weeks after injury and observed for 8 weeks. We assessed

2016 American journal of translational research

68. Management of subtotal tracheal section with esophageal perforation: a catastrophic complication of tracheostomy Full Text available with Trip Pro

Management of subtotal tracheal section with esophageal perforation: a catastrophic complication of tracheostomy Herein, we reported a catastrophic condition as the almost complete rupture of trachea associated with esophageal lesion following an urgent surgical tracheostomy performed for unexpected difficult intubation. The extent of lesions required a surgical management. We decided against a resection and an end to end anastomosis but preferred to perform a direct suture of the lesion due

2016 Journal of thoracic disease

69. Long peptic strictures of the esophagus due to reflux esophagitis: a case report Full Text available with Trip Pro

Long peptic strictures of the esophagus due to reflux esophagitis: a case report Most of benign esophageal strictures caused by gastroesophageal reflux are short segments and can be treated by an endoscopic dilatation, but cases of long-segment stenosis requiring an esophagectomy are rare.A 62-year-old woman had undergone emergency surgery for a giant ovarian tumor rupture at another hospital. A duodenal perforation occurred after surgery but improved with conservative treatment. She had (...) undergone long-term nasogastric tube placement for 4 months because she was on a mechanical ventilator and did not receive proton pump inhibitors (PPIs). Thereafter, the patient experienced dysphagia. An esophagogastroduodenoscopy (EGD) revealed circumferential reflux esophagitis (grade D) and a stricture located 25 to 40 cm from the incisor teeth. She received medical treatment with fasting and PPIs. The second EGD revealed that the reflux esophagitis had improved somewhat, but that the esophageal

2016 Surgical Case Reports

70. Emergent Esophagectomy for Esophageal Perforations: A Safe Option. (Abstract)

Emergent Esophagectomy for Esophageal Perforations: A Safe Option. Esophageal perforation is an injury associated with high morbidity and mortality. Initial management ranges from observation to esophagectomy. The aim of this study was to evaluate the relative mortality and safety of emergent esophagectomy for acute esophageal rupture when compared with elective esophagectomies.We performed a retrospective review of a prospective esophagectomy database from a single institution from 1977 (...) to 2013. Patients who were admitted for esophageal perforation and underwent esophagectomy were identified and compared with patients who underwent elective esophagectomy.In all, 3,015 patients received an esophagectomy in elective and emergent settings; 90 esophagectomies were for acute injuries (52 for benign and 38 for malignant causes). A longer median length of stay was associated with emergent esophagectomy compared with elective esophagectomy (13 versus 10 days, p < 0.0001

2015 Annals of Thoracic Surgery

71. Revisional surgery for recurrent tracheoesophageal fistula and anastomotic complications after repair of esophageal atresia in 258 infants. (Abstract)

reviewed.Forty-two (16%) patients required a total of 57 reoperations after primary repair (n=37) or esophageal reconstruction (n=5). The indications were anastomotic leakage (n=17), anastomotic rupture after endoscopic dilatation (n=5), recurrent tracheoesophageal fistula (TOF) (n=12), undiagnosed proximal TOF (n=3), recalcitrant anastomotic stricture (n=11, primary anastomosis 9, reconstruction 2), undetected proximal fistula (n=3), and inadvertently perforated jejunal graft (n=1). Anastomotic leakage (...) and rupture after dilatation were treated with rethoracotomy and suture and recurrent or undetected TOF by open repair. Strictures not manageable with repeated dilatations were resected and esophageal ends reanastomosed (n=10) or bridged with jejunum graft (n=1). Five (12%) patients required further reoperations, two after recurrent TEF (reocclusion n=1, reconstruction with gastric tube n=1), two after stricture operations (re-resection n=1, resuture after leakage n=1), and one after recurrent dilatation

2015 Journal of Pediatric Surgery

72. Esophageal Tumors, Childhood

Esophageal Tumors, Childhood Unusual Cancers of Childhood Treatment (PDQ®)—Health Professional Version - National Cancer Institute Menu Search Search Search General Information About Unusual Cancers of Childhood Introduction Cancer in children and adolescents is rare, although the overall incidence of childhood cancer has been slowly increasing since 1975.[ ] Referral to medical centers with multidisciplinary teams of cancer specialists experienced in treating cancers that occur in childhood

2012 PDQ - NCI's Comprehensive Cancer Database

73. Esophageal Rupture

Esophageal Rupture Esophageal Rupture - Gastrointestinal Disorders - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge Helicobacter pylori (...) to a study published online March 5 in the Annals... 3D Model GI Tract Video How to Insert a Nasogastric Tube SOCIAL MEDIA Add to Any Platform Loading , MD, Perelman School of Medicine at The University of Pennsylvania Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Esophageal rupture may be iatrogenic during endoscopic procedures or other instrumentation or may be spontaneous (Boerhaave syndrome). Patients are seriously ill, with symptoms of . Diagnosis

2013 Merck Manual (19th Edition)

74. Esophageal Gastrointestinal Stromal Tumor: Is Tumoral Enucleation a Viable Therapeutic Option? (Abstract)

Esophageal Gastrointestinal Stromal Tumor: Is Tumoral Enucleation a Viable Therapeutic Option? The primary objective was to evaluate the feasibility of surgical enucleation of esophageal gastrointestinal stromal tumors (E-GISTs). Secondary objectives evaluated (i) the impact of tumor enucleation on oncological outcomes, (ii) the effect of pretherapeutic biopsy on the feasibility of E-GIST enucleation, and (iii) the impact of mucosal ulceration on outcome.E-GISTs are very rare tumors (...) and esophageal resection has been the recommended approach. The feasibility and impact on outcomes of tumor enucleation are unknown.Through a large national multicenter retrospective study, 19 patients with E-GISTs were identified between 2001 and 2010. Patients who underwent either enucleation or esophagectomy were compared.Of over 19 patients identified with E-GISTs, curative treatment was surgical for 16 patients, with enucleation in 8 and esophagectomy in 8. In the enucleation group, median tumoral

2014 Annals of Surgery

75. Successful management of esophageal necrosis after endovascular repair of chronic type B aortic dissection. (Abstract)

Successful management of esophageal necrosis after endovascular repair of chronic type B aortic dissection. We report the case of a 65-year-old patient with esophageal necrosis that developed after thoracic endovascular aortic repair (TEVAR) of a previously stented, ruptured chronic type B aortic dissection. The cause of this complication may have been related to an infected mediastinal hematoma causing esophageal compression. Emergent esophagectomy was performed with success. Copyright © 2014

2014 Annals of Thoracic Surgery

76. Ruptured celiac artery aneurysm mimicking Boerhaave syndrome. (Abstract)

. Diagnostic left thoracentesis yielded bloody fluid with similar amylase level to serum. The chest computed tomographic scan showed no evidence of esophageal rupture. However, a ruptured celiac artery aneurysm with retroperitoneal hematoma extending to the posterior mediastinum and bilateral pleural space was found incidentally. Although ruptured celiac artery aneurysm is an uncommon cause for postemetic epigastralgia, acute vascular events such as the previously stated cause should be the first (...) Ruptured celiac artery aneurysm mimicking Boerhaave syndrome. Ruptured celiac artery aneurysm is a rare cause for epigastric pain and is usually detected incidentally. Atypical presentation with postemetic epigastralgia and pleural effusion usually leads physicians to make the diagnosis of Boerhaave syndrome. Herein, we report a 32-year-old woman who was diagnosed with Boerhaave syndrome initially after presenting with acute postemetic epigastralgia and predominant left side pleural effusion

2013 American Journal of Emergency Medicine

77. Esophageal Stricture (Overview)

esophageal strictures: incidence of esophageal rupture and its management in 589 patients. AJR Am J Roentgenol . 2011 Dec. 197(6):1481-6. . Al-Hussaini A. Savary dilation is safe and effective treatment for esophageal narrowing related to pediatric eosinophilic esophagitis. J Pediatr Gastroenterol Nutr . 2016 Apr 21. . Thyoka M, Barnacle A, Chippington S, et al. Fluoroscopic balloon dilation of esophageal atresia anastomotic strictures in children and young adults: single-center study of 103 consecutive (...) Esophageal Stricture (Overview) Esophageal Stricture: Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTc1MDk4LW92ZXJ2aWV3 processing > Esophageal Stricture Updated: Apr 27

2014 eMedicine.com

78. Esophagitis (Overview)

with Candida esophagitis. Illnesses that interfere with esophageal peristalsis, such as achalasia, progressive systemic sclerosis, and esophageal neoplasias, may contribute to fungal esophagitis. Initially, herpes esophagitis is manifested by the development of small vesicles that subsequently rupture to form discrete superficial ulcers on the mucosa. In immunocompetent patients, the host response promotes healing of the ulcers, but in patients who are severely immunocompromised, the condition may progress (...) Esophagitis (Overview) Esophagitis: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTc0MjIzLW92ZXJ2aWV3 processing > Esophagitis Updated: Apr 27, 2017 Author

2014 eMedicine.com

79. Esophageal Varices (Overview)

hypertension). Delayed venous phase of a selective common hepatic angiogram (same patient as in the previous image) shows the portal vein (P), with filling of the left gastric vein caused by retrograde flow feeding gastric and lower esophageal varices (arrows). Retrograde flow in enlarged umbilical veins also is seen. The final diagnosis was hepatitis C cirrhosis, hepatocellular carcinoma of the left hepatic lobe (which had ruptured into the peritoneum), and portoarterial fistula (which had developed (...) ruptured into the peritoneum), and portoarterial fistula (which had developed inside the ruptured tumor, giving rise to severe portal hypertension). This video, captured via esophagoscopy, shows band ligation of esophageal varices. Video courtesy of Dan C Cohen, MD, and Dawn Sears, MD, Division of Gastroenterology, Scott & White Healthcare. of 13 Tables Table 1. Interpretation of Surrogate Portal Venous Pressure Measurements in the Differential Diagnosis of Portal Hypertension Etiology of Portal

2014 eMedicine.com

80. Esophageal Hematoma (Overview)

. Spontaneous esophageal hematoma. Am J Gastroenterol . 1999 Dec. 94(12):3655. . Chen TA, Lo GH, Lai KH. Spontaneous rupture of iatrogenic intramural hematoma of esophagus during endoscopic sclerotherapy. Gastrointest Endos . 1999 Dec. 50(6):850-1. . Hiller N, Zagal I, Hadas-Halpern I. Spontaneous intramural hematoma of the esophagus. Am J Gastroenterol . 1999 Aug. 94(8):2282-4. . Meulman N, Evans J, Watson A. Spontaneous intramural haematoma of the oesophagus: a report of three cases and review (...) (2):123-4. . Wang AY, Riordan RD, Yang N, Hiew CY. Intramural haematoma of the oesophagus presenting as an unusual complication of endotracheal intubation. Australas Radiol . 2007 Dec. 51 Suppl:B260-4. . Xie X, Bai J, Li X. Massive intramural esophageal hematoma secondary to anticoagulation therapy for mitral valve replacement. J Card Surg . 2016 Dec. 31(12):740-741. . Marks IN, Keet AD. Intramural rupture of the oesophagus. Br Med J . 1968 Aug 31. 3(617):536-7. . Yamashita S, Takeno S, Moroga T

2014 eMedicine.com

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