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At least 649 records · Page 36Linked to original sources
PubMed1985

Follow-up examinations of conservatively and surgically treated children with hiatus hernia.

Between 1966 and 1976, 65 infants and children were treated because of hiatus hernia. The diagnosis was made radiologically in all cases and in a number of patients endoscopically. 54 patients had a forme mineure (types 1 and 2), and 11 had a forme majeure (types 3 and 4). Of the 20 patients with type 1, 16 (80%) were successfully treated conservatively; two further patients needed a secondary operation. Of 34 children with type 2, 15 (44%) were treated successfully conservatively, and four needed a secondary operation. Of ten patients with type 3, four (40%) were treated primarily conservatively with success. Two children with type 1, 11 with type 2, six with type 3, and one with type 4 had to be operated on primarily because of severe esophagitis at the time of admission. From 14 mon to 10 years after discharge from hospital, follow-up examination of 33 patients showed that one child died from another cause. In 14 of the 21 conservatively treated patients and in 12 of the 18 surgically treated patients (66% in both cases), there were no symptoms or complaints. Eight had subjective complaints, but in only four (10.5%) was there a definite complaint. Three of these four patients had associated diseases (spastic tetraplegia, operated jejunal atresia). In these patients, esophagitis was present on follow-up examination and necessitated further treatment. The treatment of choice for the forme mineure without esophagitis should be conservative, and in most cases this will be sufficient. In only a few of these patients did it become necessary to carry out a secondary fundoplication. Operation is indicated primarily in cases with esophagitis and esophageal stenosis as well as in patients with a forme majeure of the hiatus hernia.

Body Weight↗
PubMed1985

[Transluminal esophagoplasty (TE)].

The authors analyze their experience on 9 cases of esophageal stenosis dilated by "Grüntzig" type balloon catheter under fluoroscopic examination (transluminal esophagus plastica: TE). This procedure also allows dilatation of severe narrowing, offering distinct advantages represented by: low risk, easy performance, good tolerance, reduction or disappearance of disphagia. Esophageal perforation is possible, though it never appeared in author's experience.

Barrett Esophagus↗
PubMed1989

[Complications of endoscopic sclerosis of esophageal varices].

In recent years endoscopic sclerotherapy of esophageal varices has proliferated enormously, but the technique is not free of complications, which can be divided into three large areas, depending on the moment when they appear: complications due to technical errors, early complications and late complications. The authors analyze the complications in 105 patients who had a total of 385 sclerosis sessions. After describing the results and discussing them, it is concluded that the use of adequate material and sufficient technical experience are the best guarantee against the first type of complications, that hemorrhage is the most common early complication and that esophageal stenosis is the most frequent late complication. Finally, the existence of postsclerotherapy pseudo-polyps, which are asymptomatic, can pose a differential diagnosis with benign or malignant tumors of the distal third of the esophagus.

Esophageal Diseases↗
PubMedDate not supplied

[Stenosing esophagitis caused by Trichosporon beigelii: presentation of a rare case].

The Authors describe a rare case of esophageal stenosis complicated by gastroesophageal reflux due to Trichosporon beigelii in the absence of a pathologic predisposition or immunodeficiency. The diagnosis was drawn by embedding membrane fragments obtained endoscopically in Sabouraud and blood-Agar cultures. The patient was treated with antimicotics, immunostimulants, inhibitors of the gastric protonic pump, prokinetics and later underwent endoscopic dilatation combined with Savary-Guillard and pneumatic dilatators of growing diameter, until complete "restitutio ad integrum" of the esophageal lumen.

Dilatation↗
PubMed1982

[Esophageal pathology associated with achalasia].

Out of 90 patients with esophageal achalasia seen during the last decade, we found associated esophageal pathology in 46,6% of the cases. The esophagitis occurred with a frequency of 26,6%, whereas esophageal hiatus hernia was found in 14,4%, benign esophageal stenosis in 5,5%, diverticula in 2,2% and tumors in 2,2%. The role of the different ethiopatogeneic factors is discussed as well as the approach to the above mentioned entities.

Adolescent↗
PubMedDate not supplied

[Total duodenal diversion in reflux esophagitis after colic esophagoplasty].

Five patients with severe reflux esophagitis were treated by retrosternal colic esophagoplasty for esophageal stenosis of caustic origin. In 4 cases there was anisoperistaltism and in one case isopersitaltism. Treatment was by antral cologastric anastomosis in all cases, with a undojejunostomy in 3 patients and a colojejunostomy on loop in Y in the 2 others. Mortality was absent and long-term results were very good. Colojejunostomy on loop in Y is a simpler procedure not requiring gastric resection and long-term results were similar. An even less complicated variant of the latter operation that does not require colic section is also described. Prophylaxis of reflux esophagitis after colic esophagoplasty is discussed, the Roux type deviation being proposed for the treatment of cologastric ulcer after esophagoplasty.

Adult↗
PubMed1992

[Endoscopic injection sclerotherapy for esophageal varices: studies on methodology and complication].

From November 1985 to February 1991, sixty patients were randomized to three groups of intravariceal sclerotherapy: (1) many punctures of low quantity sclerosant, (2) one puncture of large quantity sclerosant, and (3) one puncture of large quantity sclerosant with transendoscopic balloon. The early effects and complications were investigated. Varices eradication was reached 91.2% in group 1, significantly higher than group 2 (58.3%) (P < 0.05), similar to group 3(89.9%). However, balloon group (group 3) required shorter duration than group 1 (12.6 vs. 21.7 days) (P < 0.05). There were no significant differences in complications, but all 6 esophageal stenosis were in group 1, recurrent bleeding was 11.4% in group 1.35.7% in group 2 and 0 in group 3 during sclerotherapy sessions. Further more, we found though attempted to inject into variceal veins, accurate intravariceal injection reached only 46.8% in accordance with venographic findings. We conclude that sclerotherapy with transendoscopic balloon seems to be more simple, safer, and required short time to produce successful variceal sclerosis.

Esophageal Stenosis↗
PubMedDate not supplied

[Outcome of patients after obliteration of esophageal varices by endoscopic sclerosis. Results of a prospective study].

The purpose of this prospective was study to investigate the course of patients after obliteration of bleeding esophageal varices by endoscopic sclerotherapy and to outline prognostic factors. Sixty-seven patients (45 men, 22 women, mean age: 53.3 +/- 14 years) were followed for a mean of 14 +/- 8 months median = 15 months-range: 1-33 months) from the time of obliteration. Etiology of portal hypertension was portal vein thrombosis in 3 patients and cirrhosis in 64, 44 of whom (65 p. 100) were due to alcoholism (Child-Pugh's class: A: 8 p. 100, B: 42 p. 100, C: 50 p. 100). Recurrence of varices was observed in 23 patients within 1.4 to 25 months (median: 6.6 months). The recurrence rate increased in a linear fashion with time. Reobliteration was achieved in one to three sessions of sclerotherapy. More than one bleeding episodes was observed more often, before sclerotherapy (p less than 0.05) and esophageal stenosis was seen less often during treatment (p less than 0.05) than in patients without recurrence. Variceal bleeding occurred in 14 patients (21 p. 100) within 0.1 to 23 months (median = 5.6), 6 of whom (43 p. 100) died. In the subgroup of alcoholic cirrhosis, absence of withdrawal was associated with a higher risk of rebleeding (p = 0.04). Fifteen patients (22 p. 100) died within 1 to 26 months (median = 12.3). They had a higher mean age (p less than 0.01) and a lower blood fibrinogen (p less than 0.05) than survivors.(ABSTRACT TRUNCATED AT 250 WORDS)

Esophageal Stenosis↗
PubMed2002

[Interventions in gastroenterology and hepatology: indications and results].

Interventional therapy and above all the endoscopic interventions have gained importance in the last years. There are a lot of interventional procedures with curative or palliative intention, which value have to be compared with surgical therapy as the therapeutical gold standard. Today the endoscopic hemostasis for ulcer or variceal bleeding are the therapy of choice with very good results. Thus the need for surgery is low. The treatment of benign esophageal stenosis is a domain of the endoscopic therapy. Dilatation with bougies or balloon dilatation get comparable results. In patients with achalasia age and comorbidity of the patients are of great importance for the choice of therapy. In young patients the botulinum toxin injection should be avoided because of a very low long-term efficiency and because surgery become more difficult after botulinum toxin injection. As colorectal cancer is a frequent tumor endoscopic polypectomy and mucosectomy are very important endoscopic procedures, because there is a possibility of cancer prevention and when risk factors are be considered a curative therapy of early colorectal cancer is possible.

Botulinum Toxins↗
PubMed2000

Variceal rebleeding and recurrence after endoscopic injection sclerotherapy: a prospective evaluation in 204 patients.

HYPOTHESIS: Eradication of esophageal varices by repeated injection sclerotherapy and maintenance of eradication using continued surveillance endoscopy may reduce recurrent variceal bleeding and death from esophageal varices. DESIGN: A prospective study of consecutive adult patients with endoscopically proved esophageal variceal bleeding. SETTING: A tertiary care university hospital in a metropolitan area. PATIENTS: Two hundred four patients (127 men and 77 women; mean age, 50.1 years; age range, 16-82 years) underwent 993 emergency and elective variceal endoscopic injection treatments with 5% ethanolamine oleate during 1992 endoscopy sessions. Most (166 [81.4%]) had cirrhosis, mainly due to alcohol abuse (131 [78. 9%]). The number of patients with each modified Pugh-Child risk grade was as follows: A, 30; B, 91; and C, 83. (The modified Pugh-Child classification comprises ascites, encephalopathy, serum albumin and bilirubin levels, and prothrombin time. Each variable is given a value of 1 to 3 with increasing impairment of liver function. Addition of the values leads to the Pugh-Child risk grades for each patient, with 5 and 6 giving grade A; 7 through 9, grade B; and 10 through 15, grade C, respectively.) RESULTS: Ninety-five patients (46.6%) rebled at a median of 17 days (range, 0-2583 days). Seventy-four patients (36.3%) had a total of 112 further bleeding episodes before eradication of varices. Varices were eradicated in 99 (87.6%) of 113 patients who survived longer than 3 months after a median of 5 injections and remained eradicated in 43 (mean follow-up after eradication, 38 months; range, 4-125 months). Rebleeding was markedly reduced after eradication of varices. Varices recurred in 56 patients, of whom only 10 rebled from recurrent esophageal varices. Cumulative survival by life table analysis was 55%, 41%, and 30% at 1, 3, and 5 years, respectively. One hundred thirty-seven patients (67.2%) died during follow-up. Liver failure was the most common cause of death. Minor complications (mucosal ulceration) occurred in 105 patients. Major complications, including a localized injection site leak (n = 9), esophageal stenosis (n = 25), and esophageal perforation (n = 5), occurred in 39 patients. CONCLUSIONS: Repeated injection sclerotherapy eradicated esophageal varices in most long-term patients. Complications related to injection sclerotherapy were mostly minor. Complete eradication of varices reduced rebleeding and death from esophageal varices.

Esophageal and Gastric Varices↗