• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.5.3-5
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• 1983

Esophageal stricture due to various caustic agents has led to decrease markedly with the improvement of the way of life and socioenvironmental change, and can be prevented with adequate procedure and management. However, there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. Esophageal stricture was treated with various kinds of bougies ; peroral esophagoscopic bougie, Hurst or Maloney type weighted bougie, endless bougie, retrograde esophageal bougie and open surgery. Recently the authors had experienced a case of severe esophageal stricture after ingestion of HCl, which was treated by gastrostomy and endless bougienage with good result.

• Journal of Chest Surgery
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• v.27 no.6
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• pp.489-493
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• 1994

Our patient was a 2.3 kg, male of 33 weeks gestation and spontaneous vaginal delivery. Copious salivary secretion, mild aspiration pneumonia episode due to tracheoesophageal fistula and intermittent cyanotic appearance due to hypoxia were noted shortly after birth. Head up position, frequent upper pouch suction, and adequate fluid and antibiotic therapy were done in incubator. Combined Chest and abdominal film was revealed gas in the stomach and an haziness in right chest with mediastinal shift to the right side. Esophagogram revealed markedly dilated proximal esophagus as blind pouch, and Two dimensional echocardiography showed the Ventricular Septal Defect. The conclusion was congenital esophageal atresia with tracheoesophageal fistula, Vogt-Gross type C, Waterston Risk Category B. Surgical correction with Beardmore anastomosis was performed extrapleurally through 3rd rib bed after the cannulation of umbilical vein and preliminary gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought down to the presenting surface of the lower esophageal segment that incised, and end to side anastomosis was underwent using interrupt suture placed through the full thickness of both upper pouch and lower esophageal segment. The postoperative patient was well tolerated and recovered uneventfully, permitted feeding on 7th postoperative day after esophagogram.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.1
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• pp.55-59
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• 2015

Gastroesophageal reflux disorder (GERD) is the most common esophageal disorder in children. Achalasia occurs less commonly but has similar symptoms to GERD. A nine-year old boy presented with vomiting, heartburn, and nocturnal cough. The esophageal impedance-pH monitor revealed nonacidic GERD (all-refluxate clearance percent time of 20.9%). His symptoms persisted despite medical treatment for GERD, and he was lost to follow up. Four years later, he presented with heartburn, solid-food dysphagia, daily post-prandial vomiting, and failure to thrive. Endoscopy showed a severely dilated esophagus with candidiasis. High-resolution manometry was performed, and he was diagnosed with classic achalasia (also known as type I). His symptoms resolved after two pneumatic dilatation procedures, and his weight and height began to catch up to his peers. Clinicians might consider using high-resolution manometry in children with atypical GERD even after evaluation with an impedance-pH monitor.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.1
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• pp.71-75
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• 2016

Esophageal candidiasis is commonly seen in immunocompromised patients; however, candida esophagitis induced stricture is a very rare complication. We report the first case of esophageal stricture secondary to candidiasis in a glycogen storage disease (GSD) 1b child. The patient was diagnosed with GSD type 1b by liver biopsy. No mutation was found in the G6PC gene, but SLC37A4 gene sequencing revealed a compound heterozygous mutation (p.R28H and p.W107X, which was a novel mutation). The patient's absolute neutrophil count was continuously under $1,000/{\mu}L$ when he was over 6 years of age. He was admitted frequently for recurrent fever and infection, and frequently received intravenous antibiotics, antifungal agents. He complained of persistent dysphagia beginning at age 7 years. Esophageal stricture and multiple whitish patches were observed by endoscopy and endoscopic biopsy revealed numerous fungal hyphae consistent with candida esophagitis. He received esophageal balloon dilatation four times, and his symptoms improved.

• Journal of Chest Surgery
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• v.52 no.4
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• pp.227-231
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• 2019

Background: There is no established surgical procedure for the treatment of epiphrenic esophageal diverticulum. The aim of this study was to compare the clinical outcomes of esophageal diverticulectomy using abdominal and thoracic approaches. Methods: We retrospectively reviewed 30 patients who underwent esophageal diverticulectomy through the thoracic or abdominal approach for an epiphrenic diverticulum at a single center between 1996 and 2018. We compared clinical outcomes, including the postoperative length of stay, time from the operation to oral feeding, leakage rate, and reoperation rate between the 2 groups. Results: The median age was 56 years. Of the 30 patients, 18 (60%) underwent diverticulectomy via the thoracic approach and 12 (40%) underwent the abdominal approach. The median hospital stay was 10 days (range, 5-211 days) in the thoracic approach group and 9.5 days (range, 5-18 days) in the abdominal approach group. The median time from the operation until oral feeding was 6.5 days (range, 3-299 days) when the thoracic approach was used and 5 days (range, 1-11 days) when the abdominal approach was used. In the thoracic approach group, the leakage rate was 16.67% and the reoperation rate was 27.78%. However, there were no cases of leakage or reoperation in the abdominal approach group. Conclusion: The abdominal approach for esophageal diverticulectomy is a feasible and appropriate alternative to the thoracic approach.

• Korean Journal of Clinical Pharmacy
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• v.29 no.3
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• pp.209-214
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• 2019

Doxycycline is frequently prescribed to treat urogenital infections or acne vulgaris. A 39-year-old man was prescribed doxycycline as a treatment for his skin infection. He took each tablet on an empty stomach in the morning, and just before going to bed with insufficient water. After taking the prescribed medication for approximately 3 weeks, he was diagnosed with esophageal ulcer. He had not experienced these symptoms before, and the drug label says that doxycycline rarely causes esophageal ulcer. After discontinuing the medication, the symptoms disappeared. Using the World Health Organization-Uppsala Monitoring Center criteria, the causality for doxycycline-induced esophageal ulcer was evaluated as "possible." Additionally, using the Naranjo scale and Korean causality assessment algorithm (Ver. 2), the causality was evaluated as "probable." Previous reports have stated that most patients who took doxycycline with insufficient water just before going to bed or in the supine position developed esophageal ulcer. Therefore, all patients taking doxycycline must be provided with detailed instructions about the appropriate administration methods.

• Journal of Digestive Cancer Research
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• v.11 no.1
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• pp.9-14
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• 2023

The prevalence of Barrett's esophagus is increasing in South Korea. Several strategies have been tried to prevent its progression to esophageal adenocarcinoma. It is questionable whether the strategies being tried in the West can be applied adequately in South Korea. However, despite the incidence of esophageal adenocarcinoma in the West, which is considerably higher than that in South Korea, the incidence of high-grade dysplasia/esophageal adenocarcinoma in population-based studies is as low as 0.23%/person-year. Therefore, in Korea, where the prevalence is lower than that, it is necessary to select high-risk groups more carefully for chemoprevention. The age of onset of gastroesophageal reflux disease-like symptoms at least once a week is related to the high-risk group rather than the presence or absence of chronic gastroesophageal reflux symptoms. The risk factors for esophageal adenocarcinoma include the patient's sex, age, smoking habit, and obesity. Proton pump inhibitors have a better preventive effect against esophageal adenocarcinoma compared to H2-receptor blockers, but their application to patients in Korea is limited due to the high number of individuals in need of treatment. Therefore, while considering the risk factors for the progression of esophageal adenocarcinoma, the administration of proton pump inhibitors should be considered for gastroesophageal reflux disease.

• Advances in pediatric surgery
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• v.17 no.2
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• pp.170-178
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• 2011

Hiatal hernia is a very rare disease in the pediatric population. However information from our esophageal atresia postoperative follow-up program has hypotheses; "Hiatal hernia may more frequently occur in postoperative esophageal atresia patients (EA group) than in the general pediatric population (GP group)" and "The tension on the esophagus after esophageal anastomosis may be an important etiologic factor of hiatal hernia in EA group". To prove the first hypotheses, we compared the incidence of hiatal hernia in the GP group with the incidence in the EA group. The Incidence in the GP group was obtained from national statistic data from Statistics Korea and Health Insurance Review and Assessment Service of Korea. The incidence in the EA group was obtained from the medical record and the imaging studies of our esophageal atresia postoperative follow-up program. To prove the second hypothesis, the presumptive risk factors for the development of hiatal hernia in EA group, such as the type of esophageal atresia, degree of esophageal gap, the stage operation and the redo-operation with resection and re-anastomosis of esophagus were analyzed statistically. The total number of patients in the EA group was ninety-nine and there were 5 hiatus hernias. The incidence of EA group (5 %) is significantly higher than incidence of GP group (0.024 %). (p=0.0001) The statistical analysis of the presumptive risk factors for hiatal hernia development in EA group failed to show any evidence of correlation between postoperative esophageal tension and the hiatal hernia. This study shows that the postoperative patients with esophageal atresia have high occurrence of hiatal hernia and should be followed up carefully to detect hiatal hernia.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.705-709
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• 2010

Background: Esophageal injury requires early and proper management. We want to determine the results of various esophageal injuries. Material and Method: We respectively analyzed 22 patients who were managed for esophageal injury between 1999 and 2009. Based on the medical records, we reviewed the causes of injury, the diagnoses, the treatment methods, the complications and the prognosis. Result: The main causes of esophageal injury were a foreign body in 9 cases (41%) and vomiting in 5 cases (23%). We treated the patients with esophageal primary repair in 12 cases (55%), abscess drainage in 4 cases (18%) and conservative management in 6 cases (27%). There was esophageal leakage in 7 cases (32%) and death occurred in 3 cases (14%). Conclusion: For minor esophageal injury, conservative management was sometimes possible to treat the esophagus, yet aggressive and urgent surgical treatment should be applied for cases of major esophageal injury, including mediastinal abscess.

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.111-116
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• 2006

Background: Perforation of the esophagus is a deadly injury that requires expert management for survival. The mediastinal contamination with microorganisms, gastric acid, and digestive enzymes results in a mediastinitis that is often fatal if untreated. Material and Method: Between January 1990 and June 2004, 38 patients with esophageal perforation were treated in our hospital. Retrospective review of these cases has been performed. Result: There were 28 males and 10 females. The mean age was 43.84$\pm$18.89 years (range $1{\~}73$ years). Spontaneous rupture was found in $34\%$ of perforations, iatrogenic perforation in $32\%$ and traumatic perforation in $34\%$. Perforation occurred in the cervical esophagus in 8 cases, thoracic esophagus in 29 and abdominal esophagus in 1. In the cervical esophageal perforation, managements were primary closure in 8 and drainage in 2. In the thoracic esophageal perforation, managements were primary closure in 14, resection in 3 and conservative management in 12. The mortality rate was $25\%$ in cervical esophageal perforation and $34.5\%$ in thoracic esophageal perforation. We revealed risk factor of esophageal perforation to be peropertaive septic condition (p=0.005). Conclusion: Most important risk factor of esophageal perforation was preoperative septic condition. Preoperative prompt and aggressive preoperative treatment may improve the survival rate of esophageal perforation.