1/10. Esophageal blue nevus: an isolated endoscopic finding.BACKGROUND: The occurrence of blue nevus has seldom been reported in extracutaneous sites and with no record in the esophagus. CASE REPORT: A blue nevus was reported in the esophagus of a 58-year-old Chinese woman. On endoscopic examination, the lesion presented as linear patches of bluish pigmentation in the esophagus. The patient was free of symptoms 3 years after the endoscopic examination. CONCLUSIONS: We believe this represents the first reported case of blue nevus in the esophagus. The clinicopathologic features, differential diagnoses, and the nature of the lesion are discussed, along with a review of the literature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/10. Congenital esophageal stenosis due to tracheobronchial remnants: a rare but important association with esophageal atresia.Congenital esophageal stenosis caused by tracheobronchial remnants occurred in eight children, six of whom had associated esophageal atresia and/or tracheoesophageal fistula. Symptoms usually began in early infancy but delayed diagnosis was a common feature. The mean lag period between presentation and definitive operation was 4.6 years (range, 1 month to 16 years). Errors in diagnosis were common. Six were initially diagnosed as having inflammatory strictures secondary to reflux esophagitis. Seven children were subjected to repeated esophagoscopy and bouginage of the "stricture" (mean no. = 3.4), with invariable failure to ameliorate dysphagia. Antireflux procedures were performed in three patients. In all children, symptoms were dramatically relieved following resection of the stenotic segment or esophageal replacement. Although a rare entity, congenital esophageal stenosis due to tracheobronchial remnants should be considered a possibility in patients with esophageal stricture, presumed to be inflammatory in nature, which fails to respond to standard therapy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/10. Hiccups and esophageal dysfunction.Presented herein are the detailed esophageal manometric, radiologic, ambulatory pH, and scintigraphic findings from a patient who developed protracted and recurrent hiccups (singultus) after a lateral medullary infarction. Because of the usually transient and benign nature of hiccups, previous reports on esophageal dysfunction during hiccups have been sporadic and confined to manometric findings. Utilizing various esophageal function techniques, the main features observed during hiccups were esophageal body dilation and aperistalsis, absent lower esophageal sphincter relaxation in response to swallowing, poor emptying of the distal two-thirds of the esophageal body, and low distal esophageal pH. Most of these features normalized in the absence of hiccups. A comparison is made of these findings during prolonged hiccups with those of esophageal achalasia.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/10. Cervical esophageal duplication cyst: MR imaging.Magnetic resonance (MR) imaging was performed in the evaluation of a cervical esophageal duplication cyst in a 9-month-old infant. The value of MR in the assessment of the origin of this cystic lesion as well as the nature of its contents is discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/10. An unusual case of oesophageal rupture treated by transhiatal oesophagectomy.Spontaneous rupture of the oesophagus is an uncommon surgical emergency. A case is presented in which the extensive nature of the rupture precluded standard methods of treatment and was treated by transhiatal oesophagectomy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/10. Vascular neoplasm of the esophagus with life-threatening hemorrhage. Report of a case.A rare case of life-threatening hemorrhage from a vascular neoplasm of the esophagus is presented. The exact nature of the lesion remained obscure in spite of careful histomorphologic analysis. After tumor extirpation no signs of recurrence were observed during a four-year follow-up period.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/10. Esophageal obstruction caused by mediastinal histoplasmosis: beneficial results of operation.A patient presented with progressive dysphagia and chest pain. Radiologic investigation showed extrinsic compression of the esophagus by enlarged, calcified, mediastinal lymph nodes. Immunologic studies suggested that this was due to previous histoplasmosis, currently inactive. The nodes were excised at thoracotomy, with complete relief of symptoms. Operative management was most appropriate because of the apparent inactivity of the infection, the severity and progressive nature of the symptoms, and the possible prophylaxis of mediastinal fibrosis, a well-documented complication of histoplasmosis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/10. Total columnar-lined esophagus: a case for congenital origin?We describe a patient with a long history of hiatal hernia, who at autopsy was found to have an esophagus that was totally lined by columnar epithelium. To our knowledge, this is the first documented case of an esophagus totally lined by columnar epithelium in an adult. Recent articles have emphasized the acquired nature of barrett esophagus, also known as lower columnar-lined esophagus. Several reports have shown the ascent of columnar mucosa from the lower to middle esophagus over time. The failure of the columnar epithelium lining the esophagus to revert back to squamous type, once the irritating stimulus is removed, casts doubt on the metaplastic nature of this lesion. We believe that barrett esophagus in a condition characterized by persistence of fetal-type epithelium and that our case represents such an occurrence.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
9/10. Endoscopic biopsy for improved accuracy in upper gastrointestinal tract diagnosis.Esophagogastroduodenoscopy has become the most accurate diagnostic method for identifying lesions of the upper gastrointestinal (GI) tract. It permits thorough inspection and a direct biopsy yielding a tissue diagnosis of surface lesions from the upper part of the esophagus to the second portion of the duodenum. The surgeon responsible for patients with upper GI tract disease should perform the endoscopic examination to gain first-hand information on the nature, extent, and location of the patient's problem. The surgeon-endoscopist gains an extra advantage, since the size and proximity of a lesion to the cardia, pylorus, or ampulla will determine surgical options available for the patient's problem. In patients with upper GI tract hemorrhage, the surgeon can determine immediately whether the bleeding is due to esophageal varices, Mallory-Weiss tear, gastric erosions, or an ulcer or tumor of the esophagus, stomach, or duodenum.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/10. Spontaneous mid-oesophageal rupture.The clinical presentation and management of spontaneous rupture of the middle third of the oesophagus is described in two patients. Early presentation and treatment in one case led to uncomplicated recovery. In the other patient late presentation and diagnosis resulted in delayed surgical intervention with an unsuccessful outcome. The nature of this rare lesion is discussed and nine previously described cases are reviewed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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