Refractory sclerotherapy-induced esophageal strictures.
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Dilatation↗
Biomedical subjects
N Tabibian
Publications and source records attributed to N Tabibian.
Serum bile acid determination for assessing patency of portosystemic shunts. Lack of value.
Serum bile acid levels were measured in eight patients with portal hypertension before and after portosystemic shunt surgery to see if the levels were useful for assessment of shunt patency. Both fasting and two-hour postprandial levels showed poor correlation with portosystemic shunting and could not be used to judge shunt patency.
Bile Acids and Salts↗
Cardiac tamponade as a result of endoscopic sclerotherapy: report of a case.
Sclerotherapy was used in the treatment of a patient with actively bleeding esophageal varices. Chest pain and a pericardial friction rub became evident on the day after sclerotherapy and resolved without therapy. Six months later the patient manifested cardiac tamponade which required pericardiectomy. The events of this case suggest that chronic pericarditis with cardiac tamponade was a direct complication of sclerotherapy. This report extends the range of reported complications and emphasizes the importance of follow-up of patients in whom transient pericardial friction rub develops after sclerotherapy.
Adult↗
Improved palliation of a respiratory-esophageal fistula with a cuffed esophageal prosthesis.
We report a case in which a traditional prosthesis failed to seal a malignant respiratory-esophageal fistula. Removal of the prosthesis and replacement with a new type with an inflatable cuff provided palliation, and allowed the patient to leave the hospital. The cuffed prosthesis provides a custom fit which should seal fistulous tracts of any shape or size, without causing tissue necrosis.
Carcinoma, Squamous Cell↗
Endobronchial malignant lymphoma: unusual manifestations--a report of two cases.
Two unusual manifestations associated with endobronchial malignant lymphoma are reported. A 58-year-old white female was first seen with massive hemoptysis requiring blood transfusion and pneumonectomy for histiocytic lymphoma (large cell type). The second case was that of a 47-year-old black male treated previously for poorly differentiated lymphocytic lymphoma (medium-sized cell type) who had a relapse in the lungs. Increasingly copious sputum production led to respiratory distress which required extensive radiation therapy and chemotherapy for its control.
Bronchial Neoplasms↗
Use of an endoscopically placed clip can avoid diagnostic errors in colonoscopy.
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Colonoscopy↗
Endoscopic needle biopsy: a comparative study of forceps biopsy, two different types of needles, and salvage cytology in gastrointestinal cancer.
One of the goals of gastrointestinal endoscopy is to diagnose whether a lesion is malignant. The desire to improve the sensitivity of biopsy-sampling techniques prompted us to compare prospectively the reliability and accuracy of obtaining tissue by forceps biopsy, needle biopsy (21 gauge 13-mm long metal needles versus 18 gauge 20-mm long plastic needles), and salvage cytology in patients with endoscopically suspected malignancy. Samples were obtained in the order of needle biopsy (the order of metal and plastic needle biopsy was randomized), forceps biopsy, followed by salvage cytology. Needle biopsies were obtained by puncturing the lesion under direct vision while aspirating with a syringe. Twenty-three patients with gastrointestinal malignancy were studied (7 esophageal, 4 gastric, and 12 colonic). Forceps biopsies were positive in 18 of 23 (78%), missing 1 gastric and 4 colon malignancies. Metal needle biopsy was positive in 16 of 19 (84%), plastic needle biopsy in 17 of 22 (77%), and salvage cytology in 20 of 22 (91%). Accuracy was increased by a combination of techniques. Endoscopic needle biopsy is a simple and rapid method to evaluate lesions seen at endoscopy and is especially useful in evaluation of submucosal lesions.
Biopsy, Needle↗
Sclerotherapy-associated esophageal ulcers: lessons from a double-blind, randomized comparison of sucralfate suspension versus placebo.
We undertook a double-blind randomized trial to assess whether sucralfate suspension would accelerate healing of sclerotherapy-associated esophageal ulcers. Consecutive patients who underwent sclerotherapy were evaluated. Patients were prospectively endoscoped 4 days (range, 3 to 5 days) after sclerotherapy. Those with ulcers greater than 5 mm in diameter were randomized to receive sucralfate suspension, 4 g/day (10 ml four times a day), or placebo. Endoscopic evaluations were done weekly for the 4 weeks of therapy. Nineteen patients survived long enough to be evaluated; complete ulcer healing was scored as success. Nine patients (13 ulcers) received sucralfate and 10 patients (17 ulcers) received placebo. At the end of 4 weeks, 78% of ulcers in sucralfate-treated patients had healed compared with 40% in the placebo group (p = not significant). Large ulcers were found to heal more slowly (p = 0.03, life table analysis) and small ulcers were disproportionally represented in patients receiving sucralfate (67% compared with 40% in the placebo group). When ulcer size was taken into account, the possible drug advantage disappeared; ulcer size appears to be a major determinant of rate of healing of sclerotherapy-associated esophageal ulcers. A large multicenter trial will be required to identify whether sucralfate accelerates postsclerotherapy esophageal ulcer healing.
Clinical Trials as Topic↗