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Biomedical subjects

E Achkar

Publications and source records attributed to E Achkar.

47 records · Page 3Linked to original sources
PubMed1983

Pancreatitis as initial presentation of cystic fibrosis in young adults. A report of two cases.

Because of marked improvement in diagnosis and management, cystic fibrosis is now more frequently noted in young adults, many of whom have only mild clinical forms. Pancreatitis is a known complication of cystic fibrosis and may occur at any time in the course of the disease; in rare instances, pancreatitis is the first presenting manifestation. The physician faced with a young adult with pancreatitis should consider cystic fibrosis in the differential diagnosis. We describe two young adults who presented with recurrent abdominal pain in whom the diagnosis of pancreatitis preceded the recognition of cystic fibrosis.

Adult↗
PubMed1981

Esophageal motility disorders in clinical practice.

Motor disorders of the esophagus are varied. Some of these disorders can be caused by an abnormality of the esophageal muscle and others are secondary to a systemic disease. In any case, dysphagia should always be regarded as an important symptom and carefully investigated. The first step is to obtain a detailed history. A specific esophageal lesion, such as stricture, ring, tumor, or esophagitis, should then be ruled out by roentgenography and endoscopy. If these two diagnostic procedures fail to show the cause of the dysphagia, esophageal manometry is helpful in identifying a specific motor abnormality. This procedure has also contributed greatly to the understanding of esophageal physiology.

Adenocarcinoma↗
PubMed1981

An aggressive approach to the medical management of peptic ulcer disease.

Studies indicate that endoscopy provides the best index for accurate diagnosis of peptic ulcer and for evaluating results of therapy. The use of cimetidine or frequent administration of a potent liquid antacid ensures initial healing of duodenal ulcers in 75% to 90% of patients. A similar, but not so clearly statistically significant, trend toward healing exists when cimetidine is used in gastric ulcers. Cimetidine also is useful in postsurgical ulcers, in the Zollinger-Ellison syndrome, and as prophylaxis (up to one year) in patients with healed duodenal ulcers. Although the long-term effects of healing ulcers and preventing relapses remain to be defined, an aggressive approach toward healing and the management of the healed state seems advisable. The frequent use of endoscopy as a diagnostic tool plus vigorous application of proved medical therapy is advocated.

Acute Disease↗
PubMedDate not supplied

Endoscopic small bowel mucosal biopsy: a controlled trial evaluating forceps size and biopsy location in the diagnosis of normal and abnormal mucosal architecture.

This study was designed to determine (1) whether the site of biopsy within the proximal small bowel affects the ability to assess mucosal architecture in general, or to confirm a diagnosis of celiac sprue specifically; and (2) whether endoscopic small bowel biopsy using standard forceps can obtain adequate biopsy specimens to detect or exclude mucosal abnormalities. Three-hundred fifty-two biopsy specimens were obtained prospectively from 26 patients (8 sprue, 2 nonspecific changes, 16 normal) with "jumbo" and standard forceps from jejunum, ligament of Treitz, fourth, third, and second portions of the duodenum. There was no difference in biopsy specimen quality from different locations. All celiac sprue patients had at least one good or excellent specimen from each location, thereby allowing the diagnosis to be made equally well from second, third, and fourth portions of the duodenum, as well as at the ligament of Treitz and jejunum. No false-positive diagnoses of celiac sprue were made. Finally, the standard biopsy forceps provided good or excellent specimens in all patients.

Biopsy↗
PubMedDate not supplied

Zenker's diverticulum.

Zenker's diverticulum is a pouch protruding posteriorly above the upper esophageal sphincter, in the Killian's triangle, an area of relative weakness. Zenker's diverticulum was thought, for many years, to occur as a result of cricopharyngeal incoordination but more recent evidence points to poor upper sphincter compliance with diminished sphincter opening and increased hypopharyngeal pressures. Small Zenker's diverticula may be asymptomatic. As they become larger, symptoms include dysphagia, food regurgitation, and a sensation of globus. The best diagnostic method is a barium swallow with attention to the cricopharyngeal area. Although gastroesophageal reflux may be responsible for many throat symptoms, the relationship of reflux to the pathogenesis of Zenker's diverticulum is speculative. The treatment of Zenker's diverticulum is surgical. There have been many variations in technique over the years. Diverticulectomy with cricopharyngeal myotomy remains the most frequently performed operation. Endoscopic treatment with or without laser stapling has been reported but is not popular in the United States.

Humans↗