1/6. Pharyngoesophageal (Zenker's) diverticulum: case report.Pharyngoesophageal pulsion diverticulum is the most common of all oesophageal diverticuli and is characterised by dysphagia, regurgitation, gurgling sounds in the neck and aspiration. This is a report of an 80-year old female who presented with progressive dysphagia, weight loss and recurrent bouts of pneumonitis. A barium swallow showed a pharyngoesophageal diverticulum and an upper endoscopy confirmed a wide ostium and no other pathology. She underwent surgical pharyngoesophageal diverticulectomy and cricopharyngeal myotomy under general anaesthesia and made complete recovery with total relief of dysphagia.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/6. Use of a nitinol stent to treat dysphagia post-laryngopharyngectomy.Permanent dysphagia occurring after laryngectomy or laryngopharyngectomy is uncommon, and when it does occur, can usually be treated by periodic dilatation under general anaesthesia. Occasionally, however, conservative treatment is insufficient, and patients require long-term feeding via a gastrostomy or jejunostomy tube. We describe the case of a man with an anastamotic stricture post-pharyngectomy who underwent insertion of a nitinol stent across the stricture for treatment of dysphagia. The patient's swallowing was significantly improved in the short-term, however, ultimately, florid granulation tissue formation led to obstruction of the stent and a disappointing long-term result. This, to our knowledge, is the first documentation of the use of a stent to treat dysphagia in a patient post-laryngectomy or pharyngolaryngectomy.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/6. stents in the oesophagus.The use of self-expanding metal stents can markedly improve the care of patients with inoperable oesophageal malignancy. The stents can be easily introduced without the need for general anaesthesia. They have fewer complications during insertion than rigid stents and fewer complications than laser therapy. With these stents lumens of up to 2.5 cm are easily obtainable. The article considers the type of patient who may be suitable for stenting, the technique of insertion, benefits and complications of their use.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/6. myasthenia gravis presenting during general anaesthesia for oesophagoscopy--a cautionary tale.We report myasthenia gravis presenting as dysphagia of acute onset in a 56-year-old female who had no other stigmata of the disease and who was generally well despite rheumatoid arthritis and hypothyroidism. She recovered respiratory function following a general anaesthetic for oesophagoscopy only when antimyasthenic treatment was instituted. She remains well to date. In patients who are known to have autoimmune diseases and who present with dysphagia, features of myasthenia gravis should be specifically sought.- - - - - - - - - - ranking = 4keywords = anaesthesia (Clic here for more details about this article) |
5/6. Anaesthesia and mitochondrial disease.mitochondrial diseases, or encephalomyopathies, are an uncommon, heterogeneous group of disorders with variable clinical course and presentation. Many of these patients present for surgery, or undergo anaesthesia in the course of investigation of their illness. Unfortunately, little information exists on their management in anaesthetic texts and the literature. We report on the anaesthetic management of a paediatric patient with mitochondrial disease, and briefly discuss the pathophysiology and anaesthetic implications of these disorders.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
6/6. Respiratory failure and cardiac disturbances in myotonic dystrophy.Cardiopulmonary abnormalities are frequently encountered in myotonic dystrophy. We present five patients with myotonic dystrophy who entered the intensive care unit in acute respiratory failure. The possible etiologic factors of pulmonary complications are reviewed. The most important is probably aspiration pneumonia. The difficulties in the treatment of the respiratory failure are emphasezed. myotonia of the chest muscles and diaphragm make artificial ventilation difficult. Recovery is delayed chiefly by swallowing disturbances. General anaesthesia is hazardous. Four patients presented cardiac arrhythmias and/or conduction abnormalities which were transient.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |