• Title/Summary/Keyword: esophageal obstruction

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A Case of Esophageal Obstruction Complicated in a Patient with Chronic Granulomatous Disease - Esophageal obstruction in Chronic Granulomatous Disease (만성육아종질환 환자에서 합병된 식도 폐쇄 사례 -만성육아종질환의 육아종성 식도 폐쇄)

  • Kim, Ji Soo;Hwang, Jinsol;Choi, Young Hun;Kim, Woo Sun;Kim, Joong Gon
    • Pediatric Infection and Vaccine
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    • v.21 no.1
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    • pp.53-58
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    • 2014
  • Chronic granulomatous disease (CGD) is an inherited immunodeficient disease characterized by recurrent infections and granuloma formation. Granulomatous obstruction of esophagus is one of the rare complications of CGD. The use of steroids and antimicrobials for esophageal obstruction by granuloma in CGD patients has been controversial due to the possibility of concomitant inapparent infection. We report a case of esophageal obstruction in an 8-year-old CGD patient showing the poor response to antibiotics therapy. However, dramatic improvement of symptoms and radiologic findings of esophageal obstruction were achieved after steroid therapy. One month after discontinuation of steroid, esophageal obstruction recurred and the patient was re-treated with steroid. After that time, he experienced one more recurrence of esophageal obstruction. This symptom subsided after antibiotics therapy without steroid and he has been followed up to the present without further relapse.

Role of Esophageal High-Resolution Manometry in Pediatric Patients

  • Prachasitthisak, Noparat;Purcell, Michael;Krishnan, Usha
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.4
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    • pp.300-311
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    • 2022
  • Purpose: Dysphagia, vomiting and feeding difficulties are common symptoms, with which children present. Esophageal function testing with high resolution manometry can help in diagnosing and treating these patients. We aim to access the clinical utility of high-resolution manometry of esophagus in symptomatic pediatric patients. Methods: A retrospective chart review was done on all symptomatic patients who underwent esophageal high-resolution manometry between 2010 and 2019 at Sydney Children's Hospital, Australia. Manometry results were categorized based on Chicago classification. Demographic data, indication of procedure, manometric findings, and details of treatment changes were obtained and analyzed. Results: There were 62 patients with median age of 10 years (9 months-18 years). The main indication for the procedure was dysphagia (56%). Thirty-two percent of patients had a co-morbid condition, with esophageal atresia accounting for 16%. The majority (77%) of patients had abnormal manometry which included, ineffective esophageal motility in 45.2%. In esophageal atresia cohort, esophageal pressurization was seen in 50%, aperistalsis in 40% and 10% with prior fundoplication had esophago-gastric junction obstruction. Patients with esophago-gastric junction obstruction or achalasia were treated by either pneumatic dilation or Heller's myotomy. Patients with ineffective esophageal motility and rumination were treated with a trial of prokinetics/dietary texture modification and diaphragmatic breathing. Conclusion: Esophageal high-resolution manometry has a role in the evaluation of symptomatic pediatric patients. The majority of our patients had abnormal results which led to change in treatments, with either medication, surgery and/or feeding modification with resultant improvement in symptoms.

Radiographic Diagnosis of Esophageal Obstruction by Persistent Right Aortic Arch in a Kitten (어린 고양이에서 우대동맥궁잔존에 의한 식도폐색의 방사선학적 진단)

  • 이기창;이희천;정성목;권오경;최민철
    • Journal of Veterinary Clinics
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    • v.20 no.2
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    • pp.248-251
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    • 2003
  • Esophageal obstruction as a result of persistence of the right aortic arch was diagnosed in a 3-month-old male Persian cat. Regurgitation right after weaning and retardation were noted in this cat. Survey radiographic signs on the lateral view include ventral deviation of the thoracic trachea caused by draping of the dilated esophagus over the dorsum of the trachea and a distinct interface of the dorsal wall of the esophagus silhouetting with the cranial thoracic hypaxial muscles. On the ventrodorsal view, the cranial mediastinum was widened with soft tissue density. The trachea was deviated to the right. In an esophagram, the segmental dilation of the esophagus with constriction of the lumen just cranial to the heart base was apparent. Thoracotomy was performed and corrective surgery was carried out. At surgery, it was confirmed that the esophagus was constricted at the cranial to the base of the heart.

Airway Obstruction Caused by Loculated Mediastinal Effusion after Ivor Lewis Operation

  • Kim, Hyun Jo
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.313-316
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    • 2014
  • Airway obstruction after esophageal surgery is quite rare, and few such cases have been reported. A 57-year-old woman who underwent the Ivor Lewis procedure for esophageal carcinoma complained of a sudden onset of severe dyspnea on postoperative day 3. Chest computed tomography scan revealed that the collection of a large volume of mediastinal fluid caused marked luminal compression on the trachea and the gastric conduit. Explorative thoracotomy revealed a clear serous fluid in the space between the trachea and the gastric conduit, and all respiratory symptoms were relieved after the fluid was drained. The possibility of tracheal compression by loculated effusion, such as chyloma, should be considered in a patient who complains of respiratory deterioration after esophageal surgery.

Radionuclide Esophageal Transit Study in the Esophageal Motility Disorders (식도 운동 질환에 있어서 동위원소 식도 통과 검사의 의의)

  • Choe, Jae-Gol;Lee, Min-Jae;Song, Chi-Wook
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.233-238
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    • 1993
  • Esophageal motility was evaluated from the analysis of 10 consecutive swallows using liquid bolus containing 0.5 mCi of $^{99m}Tc$ tin colloid. We have reviewed our experience of esophageal transit study in the 20 normal volunteers and 55 patients with dysphagia that was not related to mechanical obstruction. The purpose of this study is to measure the esophageal transit in normal subjects and in patients with various esophageal motility disorders. The overall sensitivity and specificity of radionuclide esophageal transit study in detecting esophageal motor abnormality were compared with manometric results as a gold standard, which were 80% and 100% respectively. Radionuclide transit study is a safe, rapid, noninvasive test and suitable as a screening test for esophageal motor disorders.

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Esophageal Stent in Postpneumonectomy Esophagopleural Fistula (폐전절제술후 발생한 식도흉막루 -식도스텐트를 이용한 치험 1례-)

  • 신용철;임용택;정승혁;김병렬
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.958-961
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    • 1999
  • A case of esophagopleural fistula after pleuropneumonectomy is reported. A 59 years old male underwent right pleuropneumonectomy due to tuberculous empyema. The postoperative small esophagopleural fistula was confirmed by esophagogram and was initially managed by a conservative treatment. There was a persistent fistula on follow up esophagogram, therefore we planned the next treatment modality for obstruction of the fistula. For poor general conditions and arrhythmia, an esophageal stent was applied as a non-surgical method. At first, a covered-form stent was inserted, but it migrated to the stomach after 3 months. By using an uncovered-form stent, a complete obstruction of the esophagopleural fistula was achieved.

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Esophageal Atresia with Distal Tracheoesophageal Fistula in Both Members of Monozygotic Twins (일란성 쌍둥이 모두에서 발생한 식도무공증)

  • Kim, Seong-Chul;Nam, So-Hyun;Kim, Dae-Yeon;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.15 no.2
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    • pp.157-160
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    • 2009
  • Although the incidence of esophageal atresia (EA) is higher in twins than in singletons by two to three times, EA usually affects only one member of twins. We report one pair of twins concordant for EA. A 31-year-old healthy woman bore monozygotic female twins at 36 weeks of gestation. They weighed 2,216 and 2,480 g, respectively. They had EA with distal tracheoesophageal fistula and underwent primary esophageal anastomosis on the birth day and the $2^{nd}$ day of life, respectively. Twin A also had suspicious antral obstruction and pyloroplasty was done simultaneously with esophageal repair. She needed antral web excision for continued gastric stasis one month after $1^{st}$ operation and three balloon dilatations of the esophagus. Twin B recovered uneventfully.

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Two Cases of esophageal foreign body removal using Fogarty catheter (Fogarty 카테터를 이용한 식도 이물(바둑알) 제거 2예)

  • 박시내;박경호;박준욱;여상원;조승호
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.79-82
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    • 2003
  • Unintentional foreign body ingestion is common in children, and coins are the most common foreign body ingested. Foreign body remaining in the esophagus may be associated with mucosal ulceration or esophageal obstruction and can potentially lead to significant morbidity and even death. Removal of esophageal foreign body is therefore generally recommended. Several methods are utilized including esophagoscopy in operating room, flexible endoscopy in out patient setting, fluoroscopic Foley catheter technique, and advancement using bougienage. We report two cases of esophageal foreign body(paduk stone) which were hard to be removed by usual esophagoscopic removal. Successful removal was accomplished with the aid of Fogarty catheter under the general anesthesia.

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A Case of Repeated Esophageal Foreign bodies Due to Esophageal Stricture (식도협착에 의한 반복 식도이물례)

  • 김영순;강주원;허성희;방대춘
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.13.1-13
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    • 1983
  • Sudden esophageal obstruction by a bolus of food is not a rare phenomenon. The individual is frequently elderly and has ill-fitting dentures through others may initiate this by bolting food. In adult patient there is a frequent history of alcoholic intake, the consumption of meat with improper chewing. A common anatomic abnormality leading to meat impaction of the esophagus is hiatal hernia, which is often associated with a ring or stricture. Recently authors experienced a case of repeated esophageal foreign bodies in 10 days in the patient who had esophageal stricture.

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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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