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At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

[Unusual aspects of colo-esophagoplasty in post-caustic esophageal stenosis].

The author presents 7 cases illustrating various particular aspects of coloesophagoplasty performed in cases of post-caustic esophageal stenoses. In pharyngolaryngeal stenoses the author recommends a personal technical variant of the oro-pharyngeal anastomosis. In one such case he performed a double pharyngocolic anastomosis in "Y". In two cases the author has successfully carried out retro-sternal transposition "of necessity", at 6 months and 4 years after coloesophagoplasty in the pre-thoracic variant. Intra-thoracic strangulation of the colic tube, occuring in two cases at 1 and 3 years respectively following initial surgery was resolved by colectomy of the intra-vascular type ("of verticalization").

Adult↗
PubMedDate not supplied

[Post-caustic esophageal stenosis].

This study treats the last 13-year experience of the Surgical Department from the Fundeni Hospital Bucharest (Romania) regarding the surgery of the postcaustical esophageal stenoses. The series is composed of 25 patients (10 males and 15 women), with ages between 19 and 58 years. The patients were admitted in our unit at an interval between 2 months and 20 years from the caustical ingestion. In 20 cases we preferred seriate procedures (gastrostomy or jejunostomy as a first operation, followed after 2 months to 20 years by a reconstructive procedure). The reconstructive operation was accompanied by resection of the stenotic esophagus in 15 cases (60%); in 10 cases we performed a bypassing (without resection) presternal esophagoplasty. Resection of the esophagus implied a combined abdomino-thoracic approach in 10 cases and an cervico-thoraco-abdominal approach in 5 (depending upon the extent of the lesions). The early postoperative course was complicated by anastomotic leakage's in 5 patients (20%) and by pulmonary complications in another 5 (20%) cases. There were no postoperative deaths. The late follow-up showed a good functional result in 24 patients with medium weight gain of 2.6 kilograms and a normal social reintegration. In conclusion, we consider that the esophagus resection in postcaustical stenoses is indicated when there are no counterindications, with a low morbidity when it is performed in specialized surgical services.

Adult↗
PubMedDate not supplied

[A comparative evaluation of the oxidant and antioxidant blood systems in rabbits with caustic burns of the eyes in their treatment by synthetic and natural antioxidants].

A method of provoking a caustic burn was described on the basis of experiments made in 36 rabbits (72 eyes) who were shared between 2 groups. Effects from histochrom, a natural antioxidant, and from emoxipin, a synthetic antioxidant, produced on the lipid-peroxidation parameters at early stages of ocular burn disease were studied. A higher clinical efficiency of histochrom versus emoxipin was demonstrated.

Animals↗
PubMed1992

[Caustic stenoses of the esophagus].

Oesophageal stenosis is a frequent complication of caustic burns, especially when deep injuries are present, due to the presence of scar tissue. After the treatment of initial complications and after an initial endoscopic evaluation, a few preventive measures can be decided to protect the upper part of the gastrointestinal tract. These measures include complete parenteral nutrition for some, and calibrating nasogastric tube for others; corticosteroid treatment is discussed. When stenosis is present, endoscopic dilatations can be performed. If they failed or instead of them, surgical replacement can be proposed with gastro or coloplasty. Resection of burned oesophagus prevents the risk of mucocele or cancer.

Burns, Chemical↗
PubMed1991

[Spontaneous and instrumental perforations of the thoracic esophagus (non-neoplastic, non-caustic). Apropos of 20 cases].

The authors present twenty cases of spontaneous or instrumental perforation of the thoracic esophagus (neoplastic and caustic perforations excluded). The delay before treatment was less than 24 hours in only one case. Mortality rate was 15%, concerning three patients (three cases of Boerhaave's syndrome) treated by T tube drainage. The contribution of exclusion using stapling technique should increase the indications of direct suture, which remains elective treatment. Esophagectomy retains its indications for perforations with pathologic esophagus or late diagnosis.

Adult↗
PubMed1977

[Tuberculosis and caustic eso-gastric burns. Critical reflections on one case].

The diagnostic problems which may be raised during caustic oesophago-gastric burns and concommittent tuberculosis, of which the symptoms may be masked by the richness of the initial clinical picture are discussed here. The authors emphasise the necessity of prophylactic anti-tuberculous treatment, before any surgery when there is any suggestion of tuberculosis even siabilised.

Adult↗
PubMed1990

[Caustic esophagitis: surgical management].

The authors present 28 report cases of severe caustic esophagitis who underwent surgery at the Hospital Nacional Edgardo Rebagliati Martins I.P.S.S., from 1987 to February 1991. All were treated by esophagocoloplasty and when the proximal cervical esophagus was injured, by pharingocoloplasty. Eighteen patients (64.28%) were female and 10 (35.72%) male. Whose ages ranged between 15 and 75 years with an average of 34 years. Ten patients (36%) suffered pharingocoloplasty and in the remaining 18 (64%) a esophagocoloplasty (esophagogastric colonic interposition) was made. Postoperative morbidity corresponded in 5 cases (18%) to respiratory Infections, in 3 cases (11%) pneumothorax, in 2 cases (7%) pleural effusions and only one case presented a small cervical leak. All of them were satisfactory solved by conservatory medical treatment. Only two cases (7%) with late postoperative stenosis required reintervention and a simple cervical plasty was made. There were no complications as mediastinitis, necrosis of the colon graft hemorrhage. Operatory mortality was 0% and the long term follow up of all patients is satisfactory, having our first report cases more than 4 years of postoperative follow up.

Adolescent↗
PubMed1990

[Mallory-Weiss syndrome in acute poisoning with non-caustic substances].

The authors presented the results of diagnostic and therapeutic esophagogastroduodenoscopy in the Mallory-Weiss syndrome observed in patients with acute ++non-caustic poisoning. Altogether 47 patients were investigated for suspected gastrointestinal bleeding. The Mallory-Weiss syndrome was detected in 20 (42.5%) patients. Therapeutic endoscopic intervention was performed in 5 cases of this syndrome to stop bleeding.

Acute Disease↗
PubMedDate not supplied

Emergency oesophageal stripping, an aggressive approach to acute, necrotic caustic burns of the oesophagus and stomach.

The authors describe a patient who was admitted with total necrosis of the oesophageal and gastric mucosa after ingestion of concentrated sodium hydroxide solution. An emergency total gastrectomy and blunt, thoracic oesophageal stripping was performed. Three months later, the continuity of the digestive tract was restored by a retrosternal colon interposition. The necessity of an aggressive diagnostic and therapeutic approach after the ingestion of caustics is recommended. An emergency endoscopic evaluation of the upper G.I. tract is mandatory. If a third degree oesogastric mucosal burn is diagnosed urgent laparatomy should be performed to assess transmural wall necrosis. If present an oesophageal gastrectomy should be performed as a life saving intervention.

Adult↗
PubMed1989

[Closed thorax esophagectomy in caustic stenosis of the esophagus].

The technique of oesophagectomy without thoracotomy using a stripper for oesophageal eversion has been applied to 6 cases of caustic stenosis of oesophagus in infants. This technic has been realized 6 to 18 months after the initial lesion in 5 cases, 13 years in a case. There is neither morbidity nor mortality. This procedure seems well adapted to pediatric indications of oesophagectomy.

Burns, Chemical↗
PubMed1989

[Esophagoplasty in caustic esophageal stenosis in children].

Over a period of 30 years, 53 children suffering from caustic stenosis of the oesophagus were treated by oesophagoplasty. The left colon was most often used (49), though on occasions a Gavriliu gastric tube (3) or the right ileo-colon was used (1). Technical failure occurred in 7 cases with left esophagocoloplasty and this was treated with either a gastric tube (4) or right esophagocoloplasty (3). Oesophagectomy to prevent cancer was carried out on 20 occasions after the oesophagoplasty, on 23 occasions at the same time at the oesophagoplasty, and has yet to be carried out in 6 children. Early mortality was zero; 4 uncomplicated cervical fistulae occurred; 12 anastomotic stenoses were cured by dilatation and 5 required further surgery. Death occurred in 3 children as a late event: one at 2 months, due to difficulty with deglutition, one at 2 years, due to meningococcal septicemia, and one at 3 years due to obstruction from adhesions. Peptic reflux was seen in 3/9 Gavriliu plasties and in 6/45 coloplasties. Functional sequelae were absent in 29 cases and 12 cases suffered occasional episodes of obstruction. The best procedure appeared to be posterior mediastinal esophagocoloplasty combined with resection of the damaged oesophagus.

Burns, Chemical↗
PubMed1989

[Esophagoplasty in caustic stenosis in children. Apropos of 28 cases].

28 cases of oesophagectomy for caustic stenosis in children are reported. The authors discuss the technical modalities and the evolution of ideas, especially the importance of the oesophagectomy, in front of the risk of a secondary cancerisation. This severe complication becomes accentuated with the years and prescribes in children more systematic oesophagectomy concomitant or secondary to the oesophagoplasty.

Burns, Chemical↗
PubMed1986

[Endobrachyesophagus as a sequel of esophagitis due to caustics].

Caustic ingestions show, nevertheless medical progress, many clinical and therapeutical problems; particularly risk factors of stenotic and neoplastic evolutions as well as of functional outcome are little known. A case of Barrett's esophagus after acid sulphuric ingestion is the starting point of some personal considerations, after revision of literature.

Burns, Chemical↗
PubMed1986

[Evaluation of 16 severe pharyngo-esophageal caustic stenoses. Value of the anterior approach in an ileo-colic transplant].

Results of treatment of 16 cases of severe pharyngo-esophageal stenosis of caustic origin are reviewed. Emergency treatment is described, the place of otorhinolaryngology in investigation of lesions of upper respiratory and digestive tract discussed, and a description given of a technique of esophagopharyngoplasty by right ileocolic transplant with a suprahyoidal or supraglottic anterior cervical approach with epiglottectomy. Strict selection of patients is essential, taking into account their psychiatric profile. The functional result of this operation, with its long and difficult postoperative course, was inconstant (11 of the 16 cases could be fed liquids and solids by mouth exclusively, ensuring maintenance of body weight, although endoscopic dilatation might be necessary in one or two cases), and appears to depend on the outcome of corrosive lesions and psychologic behavior of patients.

Adolescent↗
PubMed1985

[Late sequelae of caustic esophagitis].

The caustic burns of the oesophagus still play a significant role in the framework of oesophageal conditions, both in terms of therapeutic approach in the acute phase, when high morbidity and mortality rates are recorded, and of long-term consequences. These are as follows: stenoses of varying extent, carcinoma, wall deformation, oesophago-bronchial fistulae and motor disturbances. This paper is concerned with the clinical, diagnostic and therapeutic implications of these late consequences.

Bronchial Fistula↗
PubMedDate not supplied

Nasogastric intubation as sole treatment of caustic esophageal lesions.

In this partly retrospective and partly prospective study, we examined 200 patients with suspected caustic ingestion. No steroids were administered to the patients involved. Lesions in the esophagus were found in 93 patients. Thirty-two patients with deep circular burns had nasogastric tubes inserted immediately. Of these patients, two developed esophageal strictures, but subsequent dilatation was successful. No stricture formation was observed in the group of patients with noncircular lesions. We feel that this low percentage of stricture formation is due to the use of nasogastric tubes. Since neither the presence nor the severity of esophageal burns is predictable, an endoscopy should be performed in all suspected cases. In the absence of severe pharyngeal lesions, the use of a flexible fiberoptic endoscope is preferable because it also allows examination of the stomach and proximal part of the duodenum.

Adolescent↗