The extraction of a thermometer wedged in the duodenum, which utilized fibrendoscopic techniques, is described. A brief review of methods which are available to the endoscopist to retrieve ingested foreign bodies is presented.

Aged↗

PubMed1978

The Mallory-Weiss lesion: a five-year experience.

A retrospective survey has been made of patients with the Mallory-Weiss lesion who presented with upper gastrointestinal tract bleeding during the period 1972 to 1976. The lesion was diagnosed endoscopically in 78 cases, representing 7.7% of the total number of patients admitted with upper gastrointestinal tract bleeding. Patients ranged in age from 18 to 86 years (mean 43 years). The male-female ratio was 3:1. A history of retching and vomiting clearly preceded the bleeding in 60 patients. Significant alcohol intake within 48 hours of bleeding was reported in 53% of patients. Other upper gastrointestinal tract conditions, or migraine, may have induced vomiting in some instances. Previously known Mallory-Weiss lesions were rare (two patients), but 21% of patients had well documented past upper gastrointestinal tract bleeding from other causes. The tears were situated at the cardio-oesophageal junction in 47% of patients and were entirely gastric in 30%; 23% were oesophageal. Blood replacement was required in 31 patients (40%), and 16 of these were transfused with five or more units. Of those patients requiring transfusion, half had other significant pathological lesions. The mean hospital stay was four days and prolonged stay in hospital was usually necessary only in the presence of other disease. In no instance was surgery required primarily to control bleeding from mucosal tears. This study suggests that the Mallory-Weiss lesion is a relatively common cause of upper gastrointestinal tract bleeding, but that it is usually a benign condition, unless it complicates some other disorder.

Adolescent↗

PubMed1976

The histologic spectrum of Barrett's esophagus.

To define the histology of the columnarlined esophagus, we obtained esophageal biopsies from various levels with manometric control from 11 patients. There were three types of columnar epithelia above the lower esophageal sphincter: atrophic gastric-fundic-type epithelium with parietal and chief cells; junctional-type epithelium with cardiac mucous glands; and distinctive specialized columnar epithelium with a villiform surface, mucous glands and intestinal-type goblet cells. When present, specialized columnar epithelium was always the most proximal, and gastric fundic epithelium the most distal epithelium. Junctional epithelium was interposed between gastric fundic and specialized columnar or squamous epithelium. Four patients had unequivocal esophagitis in squamous epithelium, but its presence and severity did not correlate with inflammation in or length or type of distal columnar epithelium. Histoligic study of the columnar-lined esophagus demonstrated a spectrum of epithelial patterns. This heterogeneity helps to explain prior discrepant reports.

Adult↗

PubMed1976