M Macías — Page 3 | PubMed Health

PubMedDate not supplied

[Extraction of foreign bodies in the esophagus. Experience in 215 cases].

OBJECTIVE: To analyze our experience in management of foreign bodies in esophagus. BACKGROUND: At present, the flexible endoscope is usually the instrument of choice for foreign bodies of the esophagus. The rigid endoscope is less expensive, but the advantages of the flexible endoscope are numerous. MATERIAL, METHODS: Management of 215 foreign bodies of esophagus are reported. The flexible endoscope was used to manage these foreign bodies. The patients comprised 151 children and 64 adults. RESULTS: In children, coins were the commonest foreign bodies (119 cases), whereas in adults, the commonest cause was impacted meat (35 cases). Two hundred fourteen foreign bodies (99.5%) were successfully managed endoscopically. The surgery rate was 0.5%. There was no morbidity or mortality. In fifteen adults we diagnosed significant associated medical conditions: benign esophageal stricture in eleven, esophago-gastric junction carcinoma in one, two patients with esophageal motility disorders and remaining with Plummer-Vinson Syndrome. CONCLUSIONS: The forward-viewing flexible endoscope has became the instrument of choice in diagnosis and management of esophageal foreign bodies.

Adolescent↗

PubMedDate not supplied

[Palliative treatment of esophageal cancer with transendoscopic injection of alcohol].

BACKGROUND: Few patients who present with dysphagia from esophageal cancer are curable. The rates of surgical resecability are low and the reported 5-yr survival rates are < 10%. Nonsurgical, endoscopic palliation of obstructing gastrointestinal cancers has became popular with stents, Nd: YAG laser, BICAP tumor probe, self-expanding metallic stents. Because of limited availability and extraordinary cost of equipment, most gastrointestinal endoscopy units can't afford their acquisition. Endoscopic injections of ethanol are useful for palliation of malignant dysphagia. AIMS: To examine if injections of ethanol are useful, in our patients, for palliation of malignant dysphagia. PATIENTS, METHOD AND RESULTS: Six male patients with dysphagia caused by inoperable or unresecable esophageal cancer were treated by endoscopic injection of ethanol to induce tumor necrosis. Prior to treatment, patients had a mean dysphagia grade of 3.6. After treatment, an optimum dysphagia grade (mean 0.8) was achieved with a mean of 6 injections treatments. There were no complications associated with endoscopic injection of ethanol. Mean patient survival rate was 286 days (range: 36-973). CONCLUSIONS: These results suggest that injections of ethanol to induce tumor necrosis have considerable potential for palliation of malignant dysphagia in patients with exophytic neoplasm.

Adult↗