• Title/Summary/Keyword: Esophageal Diseases

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Surgical Management of the Ventricular septal Defect Complicating Myocardial Infarction -A Case Report- (심근경색에 합병된 심실중격결손증 1례 보고)

  • 최순호
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1071-1077
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    • 1988
  • Surgical treatments were performed in 765 patients of the esophageal diseases at National Medical Center from 1959 to 1982. During these periods, we experienced 945 cases of the esophageal diseases. There were 401 males and 364 females and ranging from 4 days to 76 years of age and mean age was 32.4 years. The most highest mortality noted as 23.0% in esophageal perforation cases. In esophageal strictures cases, the rate of surgical mortality was 5.4%[21/386]. The over all mortality in esophageal surgical cases was 10.8%. We want to expressed about the incidence of Corrosion Carcinoma which developed from the benign esophageal stricture as 2.2%[12/550] of total stricture and as 4.9%[12/241] of total esophageal carcinoma. And the esophagoscopic biopsy must be done who had long standing history of esophageal stricture as a preoperative evaluation purpose.

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Clinical Evaluation of the Esophageal Disease (식도 질환에대한 임상적 고찰)

  • Kim, Seong-Jun;Im, Jin-Su;Choe, Hyeong-Ho
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1305-1311
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    • 1992
  • A clincal study was performed on 124 cases of the esophageal diseases experienced at Department of thoracic & cardiovascular surgery, School of Medicine, Chosun University during 6 year period from 1986 to 1991. The result were as follows: 1. The incidence ratio of male to female in esophageal diseases was 3.6: l. 2. The most common esophageal disease was cancer and occupied 73% of the total. 3. The most common associated disease was pulmonary tuberculosis. 4. Esophageal stricuture occurs in young woman and its cause is lye and strong acid. 5. The mortality rate was 33% [2/6] in esophageal perforation

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Surgical Management of the Benign Esophageal Diseases (양성식도질환(良性食道疾患)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Park, Joo Chul;Rho, Joon Ryang;Kim, Chong Whan;Suh, Kyung Phill;Lee, Yung-Kyoon
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.298-310
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    • 1976
  • A clinical analysis was performed on 118 cases of the benign esophageal diseases experienced at Department of Thoracic Surgery, Seoul National University Hospital during 20 year period from 1957 to 1976. Of 118 cases of the benign esophageal diseases, there were 84 patients of esophagenal stenosis, 14 of esophageal perforation, 8 of esophageal atresia, 7 of achalasia, 2 of hiatal hernia, 2 of esophageal foreign body and one of esophageal diverticulum. Fifty-one patients were male and sixty-seven were female, and ages ranged from one day to sixty-four years with peak incidence in the age group of 20 to 29 years. All but one of the esophageal stenosis were caused by corrosive esophagitis and ages ranged from three to sixty-four years with peak incidence in third decade. Main symptoms of the esophageal stenosis were dysphagia, weight loss and chest pain in order and mostly began between one month and one year after ingestion of corrosive agents. Corrosive esophageal stenosis developed most frequently in middle one-third of the esophagus and about one-forth of them were diffuse. Operations were performed on 72 patients of esophageal stenosis of whom 26 patients had esophagocologastrostomy, 21 gastrostomy, 20 esophagogastrostomy, 4 esophagojejunogastrostomy and 2 pharyngogastrostomy. There were 5 deaths in the postoperative period, an operative mortality of 6.9 percent, and 20 patients had one or two complications; eight were anastomotic leaks, 6 gangrenes of replaced loop, 4 wound abscesses and others. The causes of the esophageal perforation were traumatic in 7 cases, caustics in 4 and spontaneous in 3, and the most frequent site of the perforation was lower one-third of the esophagus. Frequent symptoms of the esophageal perforation were pain, fever, dysphagia and dyspnea, and preoperatively there were mediastinitis in 8 cases, empyema in 7, lung abscess in 3 and others. All 14 patients of the esophageal perforation underwent operation: primary closure in 7 cases, drainage in 4, esophagogastrostomy in 2 and 'esophageal diversion in one. There were 4 postoperative deaths and 11 postoperative complications occurred in 7 patients. The duration of symptoms in achalasia was between 3 months and 25 years, with an average duration of 6. 2 years. Frequent symptoms of the achlasia esophagi were dysphagia, regurgitation, pain and weight loss in order. All 7 patients of achlasia underwent modified Heller's operation where 2 patients had complications, restenosis in one and esophageal perforation in another. All 8 patients of congenital esophageal atresia had distal tracheoesophageal fistula and were admitted within 5 days of life, but there were pneumonic consolidation on chest X-ray in patients. Five patients underwent one staged operation with the result of 2 deaths and one anastomotic leak.

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Patho-epidemiological Features of Esophageal and Gastric Cancers in an Endemic Region: a 20-year Retrospective Study

  • Hajmanoochehri, Fatemeh;Mohammadi, Navid;Nasirian, Neda;Hosseinkhani, Mohsen
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3491-3497
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    • 2013
  • Background: Gastric and esophageal cancers are among the most lethal human malignancies worldwide. Of all malignancies estimated in Iran (47,100), gastric and esophageal cancers were responsible for 7,800 and 3,500 deaths in 2008 respectively. The present study aimed to provide an image of patho-epidemiological characteristics with their trends during two past decades with emphasis on topographic, morphologic, and some demographic features. Materials and Methods: In a hospital-based retrospective study in 2009, all pathological reports from esophageal endoscopies and gastric biopsies through a 20 years period (1989-2008) were collected and analyzed in four interval periods(five years each). Also, all eligible samples in hospital archives were enrolled for further testing. Besides, demography, topography and morphology of all samples were determined and analyzed by statistical software. Results: No significant statistical difference was seen in frequency of espohageal and gastric tumors throughout the study. Esophageal cancer cases were older than gastric. Sex ratio was 2.33/1 and men had a higher rate of both esophageal and gastric tumors. Stomach cancer included 64.3% of all cases. Inferior third and end of esophagus were common locations for esophageal tumors whereas proximal stomach was common for gastric tumors. Squamous cell carcinoma and adenocarcinoma were common morphological types of tumors in esophagus and stomach respectively. Conclusions: Morphological trends showed an increase of esophageal adenocarcinoma and diffuse/intestinal ratio in stomach cancers. Trends in incidence from gastric cancer decreased based on topographic studies but we could not find a topographical trend toward cadia.

Diagnostic Imaging of Esophageal Diseases in Dogs (개에서 식도질환의 진단영상학적 평가)

  • 장동우;이영원;엄기동;최민철;윤정희
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.269-272
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    • 2001
  • Fourteen dogs referred to veterinary Medical Teaching Hospital, Seoul National University were diagnosed as esophageal foreign body (9 cases), megaesophagus (4 cases) and esophageal stricture (1 case). Patients showed a variety of clinical signs including regurgitation, vomiting, anorexia, hypersalivation, and retching. Survey radiographic examination included the entire esophagus, including the caudal pharynx and cranial abdomen. contrast radiographs were done to identify lesions or to characterize abnormal radiographic findings on survey films. In case static contrast studies were not sufficient were not sufficient to differentiate the diseases, dynamic fluoroscopic studies were performed. In thoracic megaesophagus, when gas filled, it provided several hallmark findings such as visualization of paired longus colli muscle and tracheal stripe sign. When gas-distended, the caudal thoracic esophagus was seen as a pair of thin, soft-tissue stripes that converged into a point overlying the diaphragm and cranial abdomen. All cases of megaesophagus could be solely identified by survey radiographs. In esophageal foreign body, 6 cases out of 9 patients had the history of having foreign body and others not. Most of esophageal foreign body could be diagnosed on survey radiographs and one case with radiolucent foreign body was confirmed by esophagram. It appeared as radiopaque material along the path of esophagus and the radiopacity was determined by its nature. Obstruction caused by foreign body eventually led to dilation of the esophageal lumen cranial to the site in 3 cases. In esophageal stricture, there was no remarkable findings on survey radiograph of the thorax. However, esophagography with barium sulfate showed the narrowing of the esophagus near hiatus. On fluoroscopy, swallowed barium was stagnated cranial to the site despite the esophageal peristalsis.

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A case of Esophageal Cancer with Pneumopericardium (식도암에 동반된 심막기종)

  • Hwang, Jin-Su;Choi, Soo-Mi;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1305-1309
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    • 1998
  • A diabetic 73-year-old man had admitted and examined gastrofiberoscopy due to dyspagia and weight loss of 6 kg during two months. He was confirmed diagnosis of esophageal squamous cell carcinoma. During the esophgography, we found the dye spillage into pericardia! space from the esophagus with air collection A following chest roentgenogram revealed a typical pneumopericardium with pericardial air filling. Although intensive care was done. he expired 4 days later. We report a case of typical pnemopericardium caused secondary to esophageal cancer.

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The Importance of Esophageal and Gastric Diseases as Causes of Chest Pain

  • Kim, Yong Joo;Shin, Eun Jung;Kim, Nam Su;Lee, Young Ho;Nam, Eun Woo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.261-267
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    • 2015
  • Purpose: Pediatric chest pain is considered to be idiopathic or caused by benign diseases. This study was to find out how much upper gastrointestinal (UGI) diseases are major causes of chest pain in pediatric patients. Methods: The records of 75 children (42 boys and 33 girls, aged 3-17 years old) who have presented with mainly chest pain from January 1995 to March 2015 were retrospectively reviewed. Chest X-ray and electrocardiography (ECG) were performed in all aptients. Further cardiologic and gastrointestinal (GI) evaluations were performed in indicated patients. Results: Chest pain was most common in the children of 6 and 9 to 14 years old. Esopha-gogastric diseases were unexpectedly the most common direct causes of the chest pain, the next are idiopathic, cardiac diseases, chest trauma, respiratory disease, and psychosomatic disease. Even though 21 showed abnormal ECG findings and 7 showed abnormalities on echocardiography, cardiac diseases were determined to be the direct causes only in 9. UGI endoscopy was performed in 57 cases, and esophago-gastric diseases which thereafter were thought to be causative diseases were 48 cases. The mean age of the children with esophago-gastric diseases were different with marginal significance from that of the other children with chest pain not related with esophago-gastric diseases. All the 48 children diagnosed with treated with GI medicines based on the diagnosis, and 37 cases (77.1%) subsequently showed clinical improvement. Conclusion: Diagnostic approaches to find out esophageal and gastric diseases in children with chest pain are important as well as cardiac and respiratory investigations.

Repeated Favorable Responses to Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors in a Case of Advanced Lung Adenocarcinoma

  • Kim, Eun-Young;Kim, Yoon-Hee;Ban, Hee-Jung;Oh, In-Jae;Kwon, Yong-Soo;Kim, Kyu-Sik;Kim, Yu-Il;Lim, Sung-Chul;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.3
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    • pp.129-133
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    • 2013
  • The presence of epidermal growth factor receptor (EGFR ) mutation is a prognostic and predictive marker for EGFR-tyrosine kinase inhibitor (TKI) therapy. However, inevitably, relapse occurs due to the development of acquired resistance, such as T790M mutation. We report a case of repeated responses to EGFR-TKIs in a never-smoked woman with adenocarcinoma. After six cycles of gemcitabine and cisplatin, the patient was treated by gefitinib for 4 months until progression. Following the six cycles of third-line pemetrexed, gefitinib retreatment was initiated and continued with a partial response for 6 months. After progression, she was recruited for an irreversible EGFR inhibitor trial, and the time to progression was 11 months. Although EGFR direct sequencing on the initial diagnostic specimen revealed a wild-type, we performed a rebiopsy from the progressed subcarinal node at the end of the trial. The result of peptide nucleic acid clamping showed L858R/L861Q.

Surgical experience of esophageal disease: report of 75 cases (식도질환의 외과적 치료 75례)

  • 박창권
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.231-242
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    • 1983
  • A clinical study was performed on 75 cases of the esophageal cancer and benign esophageal diseases experienced at Department of thoracic & cardiovascular surgery, School of Medicine, Keimyung University during 3 year period from 1978 to 1982. Of 75 cases of the surgical esophageal diseases, there were 35 patients of the esophageal cancer. 17 patients of benign esophageal stenosis, 10 patients of esophageal perforation, 4 patients of diverticulum. 3 patients of achalasia, 2 patients of congenital T-E fistula, one of upper esophageal web, one of esophageal foreign body, one of leiomyoma and patient of hemangioma. First, esophageal carcinoma was more frequent in men than in women by a ratio of five to one, and the peak incidence occurred in the 5th to 6th decade. Dysphagia was the most common symptom in 88.6 percent of our cases. The tumor was located mostly in the middle & the lower one third [91.4%]. The histological diagnosis was made in 35 cases. The squamous cell carcinoma was the most common [82.9%] and the rest was the adenocarcinoma in the lower one third [17.1%]. Thirty-five cases were operated and resection was feasible in the twenty-five patients [71.4%] with 2 cases of hospital mortality [5.7%]. All but two of the esophageal stenosis were caused by corrosive esophagitis and ages ranged from 7 to 70 years with average age of 32 years. Corrective operations were performed on 17 patients of esophageal stenosis of whom 12 patients had esophagocologastrostomy, 3 patients esophagogastrostomy and in non-corrosive esophageal stenosis one case and esophagoplasty and another case had release of external compression. There was one complication of stenosis of the esophageal perforation were traumatic in five cases, empyema in three cases, caustics in one case and postemetic in one case. 10 patients of the esophageal perforation underwent operation: primary closure in 5 cases, two staged colon interposition in 2, esophagogastrostomy in 1 and closed thoracotomy in 2 cases There were 2 complications of leakage of anastomosis sites in postoperative period. 4 patients of traction type of diverticulum underwent diverticulectomy & 3 patients of achalasia underwent modified Heller`s operation. 2 patients of congenital esophageal atresia had distal tracheoesophageal fistula & underwent one staged operation with the results of one death caused by pneumonia. Upper esophageal web had divulsion through the esophagoscope and foreign body in upper esophagus was removed through cervical esophagotomy. One case of leiomyoma in esophagus had esophagectomy and reconstruction with right colon. And one case of hemangioma in esophagus had esophagectomy & esophagogastrostomy.

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Analysis of the Relationships between Esophageal Cancer Cases and Climatic Factors Using a Geographic Information System (GIS): a Case Study of Ardabil province in Iran

  • Ahari, Saeid Sadeghieh;Agdam, Fridoon Babaei;Amani, Firouz;Yazdanbod, Abbas;Akhghari, Leyla
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2071-2077
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    • 2013
  • Esophageal cancer is a mjaor health problems in many parts of the world. A geographical information system (GIS) allows investigation of the geographical distribution of diseases. The purpose of the present study was to explore the relationship between esophageal cancer and effective climatic factors using GIS. The dispersion distribution and the relationship between environmental factors effective on cancer were measured using Arc GIS. The highest degree of spread was in Germi town and the least was in Ardabil city. There was a significant relationship between effective environmental factors and esophageal cancer in Ardabil province. The results indicated that environmental factors probably are influential in determining the incidence of esophageal cancer. Also, these results can be considered as a window to future comprehensive research on esophageal cancer and related risk factors.