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Esophageal Obstruction (esophageal + obstruction)
Selected AbstractsAngiolipoma of the esophagus: a rare clinical dilemmaDISEASES OF THE ESOPHAGUS, Issue 3 2006E. H. Jensen SUMMARY., Benign tumors of the esophagus are a rare but diverse group of lesions. Although non-malignant in biology, their presence can cause significant morbidity, including dysphagia, bleeding, gastrointestinal obstruction, and even asphyxiation. Diagnosis is frequently made using radiographic and endoscopic means, even in the absence of definitive biopsy. If discovered early, endoscopic or minimally invasive techniques may be used to excise these lesions, with essentially 100% cure rates. However, if discovered late, open excision or even esophagectomy may be required. Angiolipoma represents perhaps one of the rarest of the benign entities to affect the esophagus, with only a few cases reported in the current literature. We present the case of an 85-year-old man who developed complete esophageal obstruction due to a large, pedunculated angiolipoma, requiring open surgical excision. [source] Self-expandable metallic stents for palliation of malignant esophageal obstruction: special reference to quality of life and survival of patientsDISEASES OF THE ESOPHAGUS, Issue 1 2004K. Yajima SUMMARY., Self-expandable metallic stents (EMS) provide a common option for malignant esophageal stenosis because of the low complication rate and high dysphagia improvement rate. However, there are few studies on the functional duration of EMS and the extent of improvement of the quality of life. We retrospectively analyzed 18 patients who received EMSs in our division from 1996 to 2002. The median duration of possible food intake and the median survival period were 94.5 and 108 days. The median duration of domiciliary treatment was 56 days. Six of the 18 patients were not discharged from hospital after EMS insertion. The Karnofsky index was found to be a significant determinant of the feasibility of domiciliary treatment. One-third of the patients are incapable of obtaining the benefits of the palliative therapy. EMS deployment should be prudently selected for patients exhibiting low performance status. [source] Clinical and biochemical abnormalities in endurance horses eliminated from competition for medical complications and requiring emergency medical treatment: 30 cases (2005,2006)JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 5 2009C. Langdon Fielding DVM, DACVECC Abstract Objective , To describe the clinical and clinicopathologic abnormalities in endurance horses eliminated from competition and requiring emergency medical treatment. Design , Retrospective study over a 2-year period (2005,2006). Ten horses that successfully completed the ride in 2006 were included for comparison. Setting , Temporary equine emergency field hospital. Animals , All horses (n=30) that were removed from endurance competition and treated for a metabolic abnormality were studied. Interventions , Horses were treated with IV fluids and analgesics. Monitoring included lab work (PCV, total protein, and electrolytes) and serial physical examinations. Statistical analysis included descriptive statistics and parametric and nonparametric comparisons (ANOVA, Friedman's test, and Kruskal-Wallis) where appropriate. Measurements and Main Results , The clinical diagnoses identified included colic, esophageal obstruction, poor cardiovascular recovery, myopathy, and synchronous diaphragmatic flutter. As a group, these sick horses had lower plasma chloride and potassium and higher total plasma protein concentrations as compared with 10 healthy horses that successfully completed the ride (P<0.05, <0.01, and <0.05 for chloride, potassium, and total protein, respectively). Horses with colic had a lower PCV as compared with horses with poor recovery and those with synchronous diaphragmatic flutter (P<0.05). All horses, including colics, were treated medically and discharged to owners. Conclusions , Based on the results of this study, the prognosis for horses requiring emergency veterinary treatment after being removed from endurance competition (for metabolic reasons) appears to be good if horses are withdrawn from competition under the same criteria outlined in this study. Biochemical abnormalities tend to be mild and do not necessarily aid in delineating sick horses from successfully completing horses. None of the horses with gastrointestinal disease required abdominal surgery. [source] The use of self-expandable metallic stents for palliative treatment of inoperable esophageal cancerDISEASES OF THE ESOPHAGUS, Issue 1 2010A. Eroglu SUMMARY Most patients with esophageal carcinoma present in the advanced stage die from tumor invasion and widespread metastases. Because radical regimens are not appropriate for the majority of patients, and their expected survivals are as short as to be measured by months, the main aim of therapy is palliation with minimum morbidity and mortality. Among the palliative modalities are surgery, external radiotherapy or brachytherapy, dilatation, laser, photodynamic therapy, bipolar electrocoagulation tumor probe, and chemical ablation. The placement of self-expandable metallic stents is another method that improves dysphagia for these patients. In this study, the aim was to evaluate retrospectively the effectiveness of metallic stents deployed because of inoperable malignant esophageal stenosis and esophagotracheal fistulas. The results of 170 patients with 202 stents administered because of inoperable malignant esophageal stenosis and esophagorespiratory fistula between January 2000 and October 2008 at the Ataturk University, Department of Thoracic Surgery, were investigated. Despite epidemiological and clinical data, information regarding relief of dysphagia and quality of life were also examined. One hundred seventy patients with stents were between 28 and 91 years old (mean age 63.7 years ± 11.4 years). Ninety-seven were male and 73 were female. Stent indications were advanced tumors with distant metastasis (82 cases, 48.2%), unresectable tumors (51 cases, 30%), patients who cannot tolerate surgery or chemoradiotherapy (18 cases, 10.5%), local recurrence after primary therapy (1 case, 0.5%), esophagorespiratory fistulas from tumor or therapy (14 cases, 8.2%), and refusal of surgery (4 cases, 2.3%). Dysphagia scores evaluated by a modified Takita's grading system improved from 3.4 before the procedure to 2.6 afterward. The overall complication rate without chest pain was 31.7% (occurring in 64 cases). Mean survival was 177.7 days ± 59.3 days (2,993 days). Quality-of-life scores (The European Organization of Research and Treatment of Cancer QLQ C30) improved from 73 ± 10.3 (57,85) to 112 ± 12.6 (90,125). In therapy of malignant esophageal obstructions, metallic stents provide a significant improvement in dysphagia and require less frequent re-intervention according to other methods of dysphagia palliation such as dilatation, laser, and photodynamic therapy, nearly completely relieve esophagotracheal fistulas and improve quality of life to an important degree. [source] | ||||||||||