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Esophageal Rupture

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164. Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

the risk of infection and serious infection-related complications. The major complications of VGI include sepsis, amputation, disruption of infected anastomotic suture line with rupture or pseudoaneurysm formation, embolization of infected thrombi, reinfection of reconstructed vascular grafts, enteric fistulae to the small or large bowel, bacteremic spread of infection to other sites, and death. VGIs can be categorized broadly into those that occur in an extracavitary location, primarily in the groin (...) , abscess, sinus tract drainage, graft occlusion with distal ischemia, peripheral septic emboli, pseudoaneurysm formation, anastomotic rupture with hemorrhage (which may be life-threatening), erosion of the graft through the wound, and poor tissue incorporation of the graft. Late-onset infection (>2 months postoperatively) is less often characterized by signs of systemic sepsis. In these cases, the infection often is indolent, with local stigmata of groin erythema, painful swelling, sinus tract drainage

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2016 American Heart Association

165. Practice Guidelines for the Diagnosis and Management of Aspergillosis

accompanied by systemic antifungal therapy with voriconazole (strong recommendation; low-quality evidence) . What Are the Treatment Recommendations for Esophageal, Gastrointestinal, and Hepatic Aspergillosis? Recommendations 58. We suggest voriconazole and surgical consultation in attempts to prevent complications of hemorrhage, perforation, obstruction, or infarction (weak recommendation; low-quality evidence) . 59. We suggest antifungal therapy with voriconazole or a lipid formulation of AmB as initial

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2016 Infectious Diseases Society of America

166. Liver Disease and Pregnancy

, on their treatment with penicillamine, trientine, or zinc (strong recommen- dation, very low level of evidence). Pregnant women with suspected portal hypertension should undergo screening with upper endoscopy for esophageal varices in the second trimester (strong recommendation, low level of evidence). Pregnant women who are found to have large esophageal varices should be treated with beta-blockers and/or band ligation (conditional recommendation, very low level of evidence). Pregnant women with a history (...) , hemolysis, elevated liver enzymes, low platelets; HG, hyperemesis gravidarum; IHCP, intrahepatic cholestasis of preg- nancy. Liver Disease and Pregnancy © 2016 by the American College of Gastroenterology The American Journal of GASTROENTEROLOGY 7 whereas abdominal swelling or shock presentation can occur with hepatic rupture ( 61,62 ). Supportive management is appropriate for most contained hematomas. Surgery is indicated for those with enlarging hematomas or evidence of rupture with hemodynamic

2016 American College of Gastroenterology

167. Polyhydramnios in singleton pregnancies

OR: Odds ratio PPROM: Preterm primary rupture of membranes RR: Relativ risiko SDP: Single deepest pocket SDVP: Single deepest vertical pocket SF: Symfysefundus UL: Ultralyd 3 Indholdsfortegnelse: Nøgleord: 1 Indledning: 1 Arbejdsgruppens medlemmer: 1 Relevante koder: 1 Anvendte forkortelser: 1 Indledning: 5 Guideline: 6 Definition: 9 Diagnostik/målemetoder: 9 Klinisk vurdering: 9 Fostervandsvolumen i forhold til GA: 9 Metodevalg: 10 Grænser for AFI og DVP: 13 Fysiologi vedrørende fostervandets volumen (...) system. In: Thurnburn GD, Harding R, editors. Textbook of fetal physiology. Oxford: Oxford University Press, 1994:140-167 24. Brace RA, Wlodek ME, Cock ML, et al. Swallowing of lung liquid and amniotic fluid by the ovine fetus under normoxic and hypoxic conditions. Am J Obstet Gynecol 1994;171:764-770. 25. Kunisaki SM, Bruch SW, Hirchkl RB, et al. The diagnosis of fetal esophageal atresia and its implications on perninatal outcome. Pediatr Surg Int 2014;10:971-7. 26. Spaggiari E, Faure G, Rosseau V

2016 Nordic Federation of Societies of Obstetrics and Gynecology

168. Gastrointestinal stromal tumor of the esophagus: current issues of diagnosis, surgery and drug therapy (PubMed)

administration is downsizing of the GIST to reduce the extent of resection and to reduce the risk of intraoperative complications, including tumor rupture. The efficacy of neoadjuvant/adjuvant imatinib therapy for esophageal GISTs is poorly understood, because the reports are limited to case reports or case series with small numbers. More clinicopathological data and clinical trials for esophageal GIST are expected. (...) Gastrointestinal stromal tumor of the esophagus: current issues of diagnosis, surgery and drug therapy Gastrointestinal stromal tumors (GISTs) often arise in the stomach and small intestine, while esophageal GISTs are rare. Due to their rarity, clinicopathological data on esophageal GISTs are extremely limited, and this results in a lack of clear recommendations concerning optimal surgical management for esophageal GISTs. It is difficult to distinguish esophageal GIST from leiomyoma, the most

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2018 Translational gastroenterology and hepatology

170. Pilot study on preventing anastomotic leakage in stapled gastroesophageal anastomosis (PubMed)

after firing the stapler, and, if found, manually repairing a rupture of the mucous membrane of the anastomosis.A rupture of the mucous membrane of the anastomosis was found in four out of the 101 patients and manually repaired. No postsurgical anastomotic leakage occurred. All patients recovered well and the average postoperative stay was 10.4 days. There was no mortality within 30 days after surgery.It is critical to inspect the integrality of the luminal mucous membrane of the anastomosis under (...) direct vision in order to prevent anastomotic leakage in surgical resection of esophageal and gastroesophageal junction malignancies.© 2017 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

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2017 Thoracic cancer

171. Aortic Diseases

ulcer (PAU) and traumatic aortic injury (TAI), pseudoaneurysm, aortic rupture, atherosclerotic and in?ammatory affections, as well asgeneticdiseases(e.g.Marfansyndrome)andcongenitalabnormal- itiesincludingthecoarctationoftheaorta(CoA). Similarly to other arterial diseases, aortic diseases may be diag- nosed after a long period of subclinical development or they may have an acute presentation. Acute aortic syndrome is often the ?rst sign of the disease, which needs rapid diagnosis and decision (...) by guest on 02 April 2019patients undergoing urgent or emergent repair of acute Type A AD. 13 A similar relationship has been reported for the thoraco-abdominal aortic aneurysm repair, demonstrating a near doublingofin-hospitalmortalityatlow-(medianvolume1proced- ure/year) in comparison with high-volume hospitals (median volume 12 procedures/year; 27 vs. 15% mortality; P, 0.001) 14 and intact and ruptured open descending thoracic aneurysm repair. 15 Likewise, several reports have demonstrated

2014 European Society of Cardiology

172. Partial Splenic Embolization is a Safe and Effective Alternative in the Management of Portal Hypertension in Children. (PubMed)

patients (80.8%). Children with prior esophageal varices showed improvement after PSE with only nine (34.6%) requiring further endoscopic therapy. After PSE, patients developed transient abdominal pain, distention, fever, and peri-splenic fluid collections. Serious complications such as splenic abscess, splenic rupture, bleeding, pancreatic infarction, opportunistic infection or death were not observed. One patient experienced thrombotic complications following PSE and was later diagnosed

2019 Journal of Pediatric Gastroenterology and Nutrition

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

, corticosteroids acting locally (A07EA06) Therapeutic indication(s): Jorveza is indicated for the treatment of eosinophilic esophagitis (EoE) in adults (older than 18 years of age). Pharmaceutical form(s): Orodispersible tablet Strength(s): 1 mg Route(s) of administration: Oral use Packaging: blister (Alu/Alu) Package size(s): 20 tablets, 30 tablets, 60 tablets, 90 tablets and 100 tablets Assessment report EMA/774645/2017 Page 3/83 Table of contents 1. Background information on the procedure 7 1.1. Submission (...) indication. More information on the COMP’s review can be found in the Orphan maintenance assessment report published under the ‘Assessment history’ tab on the Agency’s website: ema.europa.eu/Find medicine/Human medicines/European public assessment reports. The applicant applied for the following indication: Jorveza is indicated for the treatment of eosinophilic esophagitis (EoE) in adults (older than 18 years of age). The legal basis for this application refers to: Article 8.3 of Directive 2001/83/EC

2018 European Medicines Agency - EPARs

174. Vascular Rings in Adults: Outcome of Surgical Management. (PubMed)

-SA and KD (n=20, 31%), double aortic arch (n=12, 18%), right arch with mirror imaging and persistent ligamentum off KD (n=7, 11%), and others (n=4, 6%). Indications for operation included dysphagia (n=43, 63%), respiratory symptoms (n=28, 43%), aneurysmal KD (n=12, 18%) and dissection/rupture (n=7, 11%).Kommerell's diverticulum was found in 51(78%) patients. Surgical approach included left-thoracotomy (n=50, 77%), right-thoracotomy (n=7, 11%), sternotomy (n=5, 8%) and hybrid-repair (n=3, 5%). A 2 (...) -stage repair with carotid-SA transposition followed by transthoracic KD excision was done in 51% of aberrant-SA (n=23). There was 1 early death. Morbidity included recurrent laryngeal nerve injury (n=5, 8%) and chylothorax (n=3, 5%). Symptomatic improvement occurred in 97%. Survival was 96.1%, 85.0%, and 73.4% at 1, 5, and 10years respectively. Dysphagia recurred in 9(14%) which included 7(11%) with esophageal dysmotility.Repair of VR in adults can be performed safely. Dysphagia is the most common

2019 Annals of Thoracic Surgery

175. Effect of local retropharyngeal steroids on fusion rate after anterior cervical discectomy and fusion. (PubMed)

levels treated, and smoking status. The case group had an overall fusion rate of 64.7%, whereas the control group had a fusion rate of 91%. When analyzed at each level of attempted fusion, the case group had a fusion rate of 81% compared to 93% in the control group. There was a single patient in the case group that developed esophageal rupture and retropharygeal abscess requiring surgical intervention with irrigation, debridement and repair at 8 months after index operation.The use of retropharyngeal

2019 The Spine Journal

176. Funtabulously Frivolous Friday Five 207

of an incurable illness, when he cannot help, the experienced Doctor will take care not to aggravate the sick person’s malady by tiring and injurious efforts; and in an impossible case he will not frustrate himself further with ineffective solicitude.”? Herman Boerhaave (1668-1738) This Dutch physician is best known today for Boerhaave’s syndrome (spontaneous esophageal rupture) which he described in 1724 in a classic example of clinicopathological correlation, when he was faced with the case of the Grand

2017 Life in the Fast Lane Blog

178. Acute Nonspecific Chest Pain ? Low Probability of Coronary Artery Disease

: chest radiography, multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), ventilation/perfusion (V/Q) scans, cardiac perfusion scintigraphy, transesophageal and transthoracic echocardiography, positron emission tomography (PET), spine and rib radiography, barium esophageal and upper GI studies, and abdominal ultrasound (US) [5,6]. Traditionally, most of these examinations have been performed during the ED visit, but there is a trend to perform outpatient testing. Variant: Acute (...) are low [8]. Thoracic calcifications, if present, can indicate pericardial disease, ventricular aneurysm, intracardiac thrombi, or aortic disease. Although chest radiographs are often normal for the presence of PE, the presence of a Hampton hump, Westermark sign, or pulmonary artery enlargement can suggest PE [9]. Mediastinal air can indicate a ruptured viscus or subpleural bleb or other acute pathology. In addition, widening of the mediastinum or an enlarged heart or aortic knob, as well as ill

2015 American College of Radiology

179. Management of Ingested Foreign Bodies in Children: A Clinical Report of the NASPGHAN Endoscopy Committee

clinical studies may be necessary to clarify aspects based on expert opinion instead of published data. Thus, these guidelines may be revised as needed to account for new data, changes in clinical practice, or avail- ability of new technology. Key Words: aortoesophageal ?stula, button battery, esophageal food impaction, foreign body ingestion, magnet, superabsorbent (JPGN 2015;60: 562–574) I n 2000 the American Association of Poison Control Centers documented that 75% of the>116,000 ingestions reported (...) of mercury, compiled data on battery ingestions published by the National Capital Poison Center in 1992 of>2300 BB ingestions during a 7-year period found no deaths and only a 0.1% prevalence of major effect (defined as life-threatening or disabling; in this series, there were 2 patients with esophageal stricture) (4). During the ensuing 18 years, however, that clinical experience changed dramatically with a follow-up paper from the National Capital Poison Center in 2010 (5). In this cohort of>8600 BB

2015 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

180. Eating Disorders

,suchashypokalemia. 141 Theseproblemsmayleadto orthostatic hypotension and syncope. Esophageal tears from excessive erosion of throat tissue can lead to serious and dif?cult-to-control bleeding. Binge eating can cause both gastric and esophageal rupture. 142 The mortality rate is estimated to be about 1% in BN patients, but more recent studies suggest that this may be an underestimate. 143,144 Indications for medical hospitalization of children and adolescents have been published by the American Academy

2015 American Academy of Child and Adolescent Psychiatry

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