1/36. Expanding mesh stent in the emergency treatment of Boerhaave's syndrome.Boerhaave's syndrome, or spontaneous esophageal perforation, is a life threatening condition demanding early diagnosis and rapid aggressive management to prevent fulminant mediastinitis and death. We describe a patient treated in an emergency situation with an expanding esophageal mesh stent to bridge the esophageal rent together with chest and mediastinal drainage, resulting in complete recovery and return to the community. We also describe the partial recovery of the stent in the convalescent period.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/36. Heterotopic sebaceous glands in the esophagus: histopathological and immunohistochemical study of a resected esophagus.A resected esophagus with numerous heterotopic sebaceous glands was examined in an attempt to determine whether esophageal heterotopic sebaceous glands are the result of a metaplastic process or a congenital anomaly. The present case concerns a 79-year-old Japanese man with numerous esophageal heterotopic sebaceous glands accompanied by superficial esophageal cancer. The resected esophagus possessed numerous heterotopic sebaceous glands, which could be seen clearly as slightly elevated, yellowish lesions. Histological examination of these glands, all of which were located in the lamina propria, revealed lobules of cells that showed characteristic sebaceous differentiation. Bulbous nests of proliferating basal cells showing sebaceous differentiation were occasionally observed in the esophageal epithelium. Of the antibodies against six different keratins used, only anti-keratin 14 labeled both the heterotopic sebaceous glands and the bulbous nests. Acquired metaplastic change of the esophageal epithelium is probably the pathogenetic mechanism involved in these unusual lesions.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
3/36. Heterotopic gastric mucosa in the upper esophagus ("inlet patch"): a rare cause of esophageal perforation.We report the case of a 21-yr-old woman who presented with a perforation of an upper esophageal ulcer on a patch of gastric-type mucosa. Despite surgical closure of the perforation and reinforcement with a pleuro-muscular flap the patient developed an esophageal leakage and died in the postoperative period. Heterotopic gastric mucosa in the upper esophagus is usually an asymptomatic abnormality, discovered incidentally during endoscopic studies carried out for some other reason; however, complications secondary to the inlet patch acid secreting capacity can arise, and this has to be kept in mind to elude life-threatening conditions.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
4/36. Intravenous immunoglobulins as treatment of life threatening esophageal involvement in polymyositis and dermatomyositis.Esophageal involvement is considered a major cause of morbidity and an indicator of poor prognosis in polymyositis (PM) and dermatomyositis (DM). We describe 3 patients with steroid resistant PM/DM with life threatening esophageal involvement, resulting in impossible oral feeding and enteral nutrition with a gastric tube. All patients had both dramatic and rapid improvement of all clinical manifestations after initiation of intravenous immunoglobulin (IVIG) therapy. Swallowing disorders completely disappeared after the second infusion of IVIG, which permitted normal oral feeding and ablation of the gastric tube. Our findings suggest IVIG should be considered the treatment of choice in such cases.- - - - - - - - - - ranking = 5keywords = life (Clic here for more details about this article) |
5/36. Oesophageal rupture in a patient with postoperative nausea and vomiting.rupture of the oesophagus (Boerhaave's syndrome) is a rare complication of forceful or suppressed vomiting. postoperative nausea and vomiting is common but does not usually lead to life-threatening complications. A case of oesophageal rupture in a man who experienced postoperative nausea and vomiting after an uncomplicated procedure is described in this report. delayed diagnosis mandated conservative treatment. The clinical presentation, diagnosis and management of oesophageal rupture is discussed.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
6/36. Congenital diaphragmatic hernia associated with a gastroesophageal duplication cyst: a case report.Severe left congenital diaphragmatic hernia was diagnosed in a baby prenatally, and she underwent hernia repair on the sixth postnatal day of life. She was found to have a huge symptomatic gastroesophageal duplication cyst on day 24 of life. A thoracoabdominal dissection allowed successful cyst excision. J Pediatr Surg 36:626-628.- - - - - - - - - - ranking = 2keywords = life (Clic here for more details about this article) |
7/36. Quality-of-life study on four patients who underwent esophageal resection and delayed reconstruction for Boerhaave's syndrome.Boerhaave's syndrome is the condition of spontaneous rupture of the esophagus as a consequence of the strain of emesis with or without predisposing esophageal disease. It is a condition with high mortality. We describe four patients who underwent a transthoracic esophagectomy to remove the rupture of the intrathoracic esophagus, closure of the esophageal gastric junction, fashioning of a feeding gastrostomy, and formation of a left cervical esophagostomy. Three patients underwent reconstruction with subcutaneous colon. We suggest that this method of management may be considered where primary repair is impossible in those patients too ill for prolonged reconstruction or as a salvage procedure where other methods have failed. The poor quality of life after esophagectomy is improved by reconstruction. Other surgical options include covering the repaired opening with a circumferential wrap of pleura, chest wall muscle, or omentum or closing the repair around a T-tube of large caliber. Esophageal exclusion using absorbable staples is another approach.- - - - - - - - - - ranking = 5keywords = life (Clic here for more details about this article) |
8/36. Successful treatment of Boerhaave's syndrome with endoscopic insertion of a self-expandable metallic stent: report of three cases and a review of the literature.Boerhaave's syndrome is a rare but life-threatening condition which presents a diagnostic as well as therapeutic challenge. early diagnosis and prompt surgical repair are critical for survival; however late recognition of esophageal rupture is not unusual. A variety of nonsurgical approaches have been proposed, particularly in the case of delayed diagnosis. In recent years, the insertion of a metallic stent has been described as a promising modality in the treatment of spontaneous esophageal rupture. We report three cases of Boerhaave's syndrome treated with self-expandable metallic stents and review previously published cases.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
9/36. Boerhaave syndrome with atypical clinical presentations diagnosed by computed tomography.Spontaneous rupture of esophagus (Boerhaave syndrome) is a life-threatening emergency requiring immediate surgical management. The diagnosis is often delayed and results in high mortality and morbidity. Typical clinical presentations are postprandial vomiting and subsequent chest or back pain, which alert the clinicians to take chest film and esophagogram for diagnosis. We presented a case of Boerhaave syndrome with atypical presentation mimicking dissecting aortic aneurysm, which was diagnosed by computed tomography.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
10/36. Dieulafoy's lesion of esophagus.Dieulafoy's lesion is a rare arterial malformation that can cause massive gastrointestinal hemorrhage. The lesion occurs most commonly in the proximal stomach. The esophagus is not a common location for this lesion. We present the case of a 25-year-old woman who was admitted to our emergency unit with the findings of hematemesis and melena. Early upper gastrointestinal endoscopic examination revealed a Dieulafoy's lesion, which was located in the distal esophagus. Endoscopic band ligation stopped the bleeding successfully. The patient was discharged 3 days after the band ligation without any complications. Dieulafoy's lesion may cause severe, life-threatening bleeding. Endoscopic diagnosis can be difficult because of the small size and obscure location of the lesion. An abnormally dilated artery that penetrates through the mucosa constitutes the etiology. endoscopy plays an important role in the diagnosis and treatment of this pathology. Despite widespread awareness of this entity, it may present a real challenge for the endoscopist due to the small size and hidden location of the lesion. The endoscopic approach to occult gastrointestinal bleeding for the diagnosis of vascular malformations is accepted as a quick and safe diagnostic method.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
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