• Title/Summary/Keyword: Esophageal stricture

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Iatrogenic Esophageal Perforation - Patterns of Injury, Presentation, Management, and Outcome - (의인성 식도 파열 - 기전, 치료 및 성적 -)

  • 김영진;이철주;소동문;류한영;노환규;문광덕
    • Korean Journal of Bronchoesophagology
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    • v.5 no.1
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    • pp.30-35
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    • 1999
  • Between 1994 to 1998, 7 patients had taken emergency operations by iatrogenic esophageal perforation. To evaluate patterns of injury, clinical presentation, and treatment options for patients, we reviewed all the 7 patients who had gotten transmural injury to the esophagus during dilatations or stenting procedures at our hospital. The primary diagnosis of the patients were as followings , two were achalagia and remaining five were corrosive esophageal strictures. Chest pain, fever, tachycardia were the early signs after esophageal perforation. The sites of perforation were thoracic esophagus in all cases and all of them underwent operation within 8 hours of initial injury. There were no postoperative mortality. Complications were developed three cases: stricture of anastomotic site, mediastinitis due to graft failure of colon and pleural empyema.

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Management of Benign Esophageal Strictures in Children

  • Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.4
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    • pp.211-215
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    • 2017
  • Esophageal strictures are seldom in children. In many countries, accidental ingestion of corrosives is a major cause of risk for stricture formation. Therefore, their management is a challenge. Safety and long-term efficacy of esophageal dilation for benign esophageal strictures has been confirmed in children. Because most children with structures are toddlers or younger, balloon dilatation is often preferred over bouginage. There is increasing evidence that short duration administration of high doses steroids may be of benefit in some specific situation (IIb esophagitis according to Zargar classification). Mytomycin-C application needs to be further evaluated. Stenting was reported to be successful in some refractory cases.

Esophageal Reconstruction by Hypopharyngointestinal Anastomosis in Corrosive Upper Esophageal Stricture (부식성 상부식도 협착증에서 하인두-장 문합에 의한 식도재건술)

  • Park, Jae-Kil;Lee, Sun-Hee;Chang, Yun-Hee;Jin, Ung;Kwack, Moon-Sub;Kim, Se-Wha;Chun, Sung-Won
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.893-898
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    • 1998
  • Material and Method: Esophageal reconstruction by the hypopharyngointestinal anastomosis was done in 7 patients of corrosive upper esophageal stricture at St. Mary's Hospital from August 1995 to January 1997. Result: There were one male and six female patients ranging from 20 to 63 years of age. The causative agents were acid in 6 patients and alkali in 1 patient. The esophageal reconstruction was made by hypopharyngcolojejunostomy in 4 patients and hypopharyngocologastrostomy in 3 patients. There were no operative mortalities. One patient developed anastomotic stenosis but others were free from dysphagia. All gained 4 kg to 13 kg of body weight during the follow-up period. Conclusion: In this experience right colon and terminal ileum including ileocecal valve was revealed as a good substitute for the esophagus and the esophageal reconstruction by hypopharyngocologastro (jejuno)stomy seems to be a satisfactory method with acceptable morbidity and mortality in corrosive upper esophageal stricture patient.

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Transhiatal Esophagectomy after Instrumental Esophageal Perforation (식도확장술 후 발생한 식도천공의 식도 열공을 통한 식도적출술 치험 1례)

  • 정일영
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.714-716
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    • 1994
  • Perforation of the esophagus, with any of its possible consequences, consetitutes an emergeny. We are reporting one case of transhiatal esophagectomy with esophagogastrostomy. The cause of esophageal perforation was baloon dilatation with underlying stricture. We recognized immediately intrathoracic perforation through routin check of Chest PA and confrormed dye leakage through esophagogram. She underwent emergency operation.

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Clinical Application of an Image-Guided Intervention in Three Dogs

  • Choi, Minsik;Kwon, Dohoon;Ahn, Jisoo;Ko, Minjung;Ahn, Jiyoung;Jung, Joohyun;Kim, Hakhyun;Kang, Ji-Houn;Chang, Dongwoo
    • Journal of Veterinary Clinics
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    • v.37 no.2
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    • pp.100-105
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    • 2020
  • A 9-month-old, 11.3 kg, intact, male, mixed-breed dog was referred for treatment of cor triatriatum dexter (CTD); a 5-month-old, 1.9 kg, intact, male Maltese for pulmonic stenosis (PS); and a 3-year-old, 6.62 kg, intact, female West Highland white terrier for esophageal stricture with regurgitation. A balloon catheter intervention was performed in the dog with CTD, and subsequent color Doppler ultrasound and abdominal ultrasound showed normal blood flow across the perforated membrane dividing the right atrium and the disappearance of the severe ascites present before treatment. Balloon catheter intervention in the dog with PS reduced the blood flow through the stenosis from 5.82 m/s to 3.97 m/s. In the dog with esophageal stricture, balloon catheter intervention widened the esophagus and no subsequent regurgitation was observed. Balloon catheter intervention is an interventional radiology procedure that represents a definitive treatment option for various stenotic lesions in dogs, including CTD, PS, and esophageal stricture. Although interventional radiology procedures for these diseases have already been reported, details of procedures and successful outcome have not been reported in Korea.

Anastomotic Complications after Esophageal Reconstruction (식도재건술후 문합부 합병증)

  • Lee, Chul-Burm;Hahm, Shee-Young;Kim, Hyuk;Jung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho;Baik, Hong-Kyu
    • Korean Journal of Bronchoesophagology
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    • v.6 no.1
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    • pp.62-71
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    • 2000
  • Background: For the purpose of reducing operating time and rate of anastomotic leakage, we have performed esophagovisceral anastomosis with an EEA stapler using the largest size possible. If any difficulty in the approach of the EEA stapler was encountered one-layer interrupted hand-sewn anastomosis. Because the rate of postoperative benign anastomotic stricture was higher than expected, a retrospective study was done on all patients who underwent esophageal reconstruction. Material and Method: Over a period of 3 years from January 1996 to December 1998, we performed esophageal reconstructions on 30 patients. Patients were divided into two groups ; EEA stapler group(Group Ⅰ) comprised of 21 patients and hand-sewn group(Group Ⅱ) comprised of 9 patients.Result:The hospital mortality was 6.67 %(2/30) and the anastomotic leakage rate was 3.33 %(1/30). Among the discharged patients, the rate of recurrent anastomotic tumor was 3.57 %(1/28) and the rate of benign anastomotic stricture stricture rate was 35 %(7/20) in Group Ⅰ and 12.5 %(1/8) in Group Ⅱ, which was not significant. Conclusion: Although nontumor benign stricture was significantly higher in Group Ⅱ than in Group Ⅰ(p=0.0492), the incidence of anastomotic complications did not differ between the two groups. The one-layer interrupted hand-sewn esophagovisceral anastomosis by maintaining a wide lumen and close approximation of mucosa to mucosal layers with evenly spaced sutures could be one of the preferred surgical method to reduce benign anastomotic strictures.

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Acute Esophageal Stricture After Induction Chemotherapy for Acute Leukemi - Report of a case - (급성 백혈병의 유도 화학요법후에 발생한 급성 식도협착)

  • Yoon, Hoo-Sik;Chang, Ki-Kyung;Kang, Jeong-Soo;Kim, Hun;Kim, Ho-Kyun;Kim, Byung-Chang;Chun, Bong-Kwon
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.549-551
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    • 1998
  • Although dysphagia in patients with acute leukemia is usually related to reflux esophagitis, infectious esophagitis, chemotherapy1) and leukemic infiltration2), acute esophageal stricture resulting from chemotherapy in the patient with leukemia is very rare. A 40-year-old man with acute myelogenous leukemia was admitted for operation of esophageal stricture which was developed within 1 month of chemotherapy. An esophagectomy and esophagogastrostomy with pyloroplasty was carried out. Histology showed mucosal infiltration of mononuclear cells and transmural fibrosis involving submucosa and the muscle layer.

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Comparison of Had-Sewn and Mechanical Esophagogastric Anastomosis After Esophageal Resection for Cancer (식도암수술시 식도-위연결부 수기봉합과 기계봉합의 비교)

  • Shin, Jae-Seung;Choi, Young-Ho;Kim, Kwang-Taik;Hwang, Jae-Joon
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.143-152
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    • 1999
  • Background : the technical modality of esophagogastric anastomosis plays an important part in the factors leading to anastomotic leakage and stricture. Objective : The objective of this study was to compare the leakage and stricture rates between the different anastomosis techniques. Materials and Methods : A retrospective study was undertaken in the patients with esophageal cancer who underwent a esophagectomy. Hand-sewn anastomosis was performed in one layer with interrupted sutures(Manual group). The stapler group was divided into two subgroups, such as PCEEA group and Endo-GIA group. Results : The differences of preoperative patient profiles between the groups were not significant. Overall mortality fates were 5% in manual group, 5% in PCEEA group and 11.5% in Endo-GIA group. Fewer anastomotic leakage occurred in manual group(5%) than in PCEEA group(10%) or in Endo-GIA group(15.4%). The postoperative stricture rate was higher in PCEEA group(35%) than in manual group(5%) or in Endo-GIA group(0%) Conclusion : Statistically, there were no significant differences in the anastomotic leakage and stricture rates between the hand-sewn and mechanical anastomosis. But the stricture rate was lower in the group using the linear stapling device and the leakage rate was lower in the hand-sewn group than the other groups.

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A Case of Metastatic Ampulla of Vater Cancer Achieving Cure (고형물 삼킴장애로 내원한 환자 1례)

  • Weon Jin Ko;Won Young Park;Jun-Hyung Cho;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.82-84
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    • 2014
  • We report a case with dysphagia for solids. A 51-year-old man with benign esophageal stricture was transferred for endoscopic treatment. He had lye ingestion history at 9 years old and underwent esophagectomy with right colonic interposition for the treatment of the benign esophageal stricture. But his symptom was acting up 2 years ago and lasted afterward even though he had underwent endoscopic treatments for dysphagia several times, including balloon dilation and stent insertion. He had polypoid enhancing wall thickening around anastomosis site of stomach with perigastric soft tissue density and suspicious nodular extension to omentum on the small bowel computed tomography. So he had a surgical resection of small bowel and jejunojejunostomy, and the pathological result was adenocarcinoma, intestinal type with soft tissue infiltration. Later he underwent total gastrectomy with segmental resection of interpositional colon and segmental resection of duodenum and ileo-colic anastomosis revision. And recently he has been on chemotherapy.

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A Case of Pyloric Obstruction Developed after Upper GI Barium Study in Patients with Caustic Injury on Gastrointestinal Tract (부식제에 의한 위장관 손상 환자에서 상부 위장관 조영술 후 발생한 위유문부 폐쇄 1례)

  • Kim, Jeong-Goo;Cho, Hye-Jin;Lee, Seung-Hee;Kim, Pum-Soo;Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.1 no.1
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    • pp.51-55
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    • 2003
  • Caustic ingestion can produce a progressive and devastating injury to the esophagus and stomach, In the acute stage, perforation and necrosis may occur. Long-term complications include esophageal stricture, antral stenosis and the development of esophageal cancer. Endoscopy should be performed as soon as possible in all cases to evaluate the extent and severity of damage, unless there is evidence of perforation. Endoscopy is the diagnostic procedure of choice. However, when the endoscopy cannot be passed through due to esophageal stricture, upper GI barium studies may be useful as a follow-up measure and in the evaluation of complications. A 44-year-old man visited our hospital complaining frequent vomiting 1 hour after ingestion of unknown amount of hydrochloric acid. At the time of arrival, the patient's oral cavity was slightly swollen and erythematous. On the endoscopic examination fourteen hour after the caustic ingestion, marked swelling of the arytenoids and circumferential ulceration with brown and black pigmentation at the upper esophagus were observed. Four weeks after the caustic injury, upper esophageal narrowing was observed and then the scope could not be advanced to the stomach. Upper GI barium study performed at that time revealed diffuse luminal narrowing of the esophagus and concentric luminal narrowing from prepyloric antrum to pylorus with disturbance of barium passage. At a week after the Upper GI study, through endoscopic examination after bougie dilatation of the esophagus, barium impaction in the stomach and the pylorus was noticed.

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