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At least 253 records · Page 14Linked to original sources
PubMed1983

[Ultrastructural changes in tissues in postburn cicatricial esophageal stenosis during bougienage and prolonged intubation].

The ultrastructure of tissues in postburn esophageal strictures was studied in 24 patients varying in ages from 23 to 70 years with the postburn period ranging from 1 1/2 months to 36 years. Biopsy samples for the study were collected during fibroesophagoscopies before treatment, after bougienage and longterm intubation with the Tkachenko tube. Before treatment, pathologically altered granulation tissue forming the surface of ulcerated esophageal strictures was found to contain such mature forms of fibroblasts as collagenoblasts with moderate collagen-producing activity, myofibroblasts, and fibrocytes. Mechanical effects of bougienage and intubation of the esophagus stimulated formation of young granulation tissue in the area of ulcerated strictures, intubation of the strictures stimulating both biosynthesis and catabolism of collagen. Mature forms of fibroblasts of young granulation tissue formed in bougienage were represented by collagenoblasts with intensive collagen-producing activity, myofibroblasts, fibrocytes, and after long-term esophageal intubation also by fibroclasts.

Adult↗
PubMed1997

Esophageal atresia/tracheoesophageal fistula and associated congenital esophageal stenosis.

BACKGROUND: The association of congenital stenosis of the distal esophagus (CES) in children with esophageal atresia/tracheoesophageal fistula complex (TEF) has been described but is thought to be rare. Most reports have been of individual or small numbers of cases. OBJECTIVE: The objective of the study was to evaluate the incidence, clinical and radiographic features of CES associated with TEF, and to compare the clinical and radiographic features of CES with acquired anastomotic strictures in TEF patients. MATERIALS AND METHODS: A retrospective review was undertaken of the records and radiographs of 225 infants with primary TEF repair over a 26-year period. RESULTS: A total of 18 of 225 (8 %) cases of CES associated with TEF and 43 of 225 (19 %) cases of anastomotic strictures were identified. CES was typically a relatively long, smooth circumferential narrowing at the junction of the mid-esophagus and distal esophagus, with normal-caliber esophagus above and below; anastomotic strictures, in contrast, were focal. Diagnosis of CES was delayed in 10 cases and missed on one or more fluoroscopic studies in 14 children. Symptoms, including feeding and respiratory problems and foreign body impaction, were common in both CES and anastomotic strictures; repeated esophageal dilatations were usually necessary. Esophageal perforation complicated dilatation in 6 (33 %) young children with CES, but none of the children with anastomotic strictures (P < 0.001). CONCLUSION: CES in combination with TEF is not rare and usually produces clinical symptoms. The diagnosis may be missed or delayed unless specifically evaluated surgically and radiologically. Esophageal dilatation in CES is potentially hazardous with a high risk of perforation, especially in young children.

Dilatation↗
PubMedDate not supplied

[Surgical treatment of esophageal stenosis caused by reflux].

From 1976 to 1993, among 582 patients with reflux esophagitis seen at our Institution, 164 (28%) presented with an esophageal stricture, and 68 of these (41%) underwent surgical treatment. The male to female ratio was 1.6:1, and the median age 51 (range 15-78). Thirteen of the 68 patients (19%) had an associated Barrett's esophagus. Esophageal manometry revealed scleroderma in nine individuals (13%). In 11 patients (16%) observed before 1985 the stricture was not dilatable. Surgical therapy consisted of fundoplication (n = 39), Collis gastroplasty plus fundoplication (n = 10), total duodenal diversion (n = 4), and esophageal resection (n = 15). The mortality rate was 4.4%: two patients died of necrosis of the colon transplant and one of acute pancreatitis. The median follow-up was 27 months (6-129). Esophageal sparing procedures significantly reduced the need of further endoscopic dilatation (p < 0.001). Standard fundoplication was successful in 30 of 39 patients (77%). Regression of Barrett's epithelium was not recorded after any of the conservative surgical procedures.

Adolescent↗