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At least 1,081 records · Page 60Linked to original sources
PubMed1983

Radiological evaluation of visceral injuries in the battered child syndrome.

Diagnostic imaging plays an important role in the recognition, evaluation, and follow-up of visceral injuries in the battered child syndrome. Conventional radiography is important for the diagnosis of associated skeletal fractures, pulmonary parenchymal injury, gastric dilatation, and pneumoperitoneum. An upper gastrointestinal series is the examination of choice in suspected intramural duodenal hematoma. Ultrasonography is helpful in the diagnosis of retroperitoneal hematoma, acute traumatic pancreatitis, and pancreatic pseudocyst. Nuclear scintigraphy is valuable if injury is limited to the liver or spleen. CT is the imaging modality of choice for assessing generalized blunt abdominal trauma as well as evaluating the extent of injuries to the liver, spleen, pancreas, kidneys, and mesentery.

Abdominal Injuries↗
PubMedDate not supplied

[Caustic lesions of the upper digestive tract. Apropos of 191 cases].

The authors report 191 cases of caustic burns of the upper gastro intestinal tract. HCL is the most incriminated caustic. 6 of them are severe cases: 2 are dead immediately, 4 were operated in emergency and 3 died. The staging based on fibroendoscopy allow us to make a prognosis. 43% of the cases stage III and 14% stage II developed a stenosis. A nasogastric tube is performed at 135 cases. It's used for an enteral artificial feeding and for oesophageal stenting in burns liable to cause stenosis. Through the results of this study and a review of the literature we may establish a therapeutic schema adapted to our conditions.

Accidents↗
PubMed1983

Isovolumetric indices and humoral cardioactive substance bioassay during clinical and experimentally induced gastric dilatation-volvulus in dogs.

Plasma collected from 6 experimentally induced and 29 clinical cases of gastric dilatation-volvulus was assayed for cardioactive substances utilizing isolated canine papillary muscles. The results were correlated with in vivo isovolumetric indices of myocardial contractility observed during experimental gastric dilatation-volvulus in the dog. Cardioactive substances were not detected during experimental gastric dilatation-volvulus. Two experimental dogs showed a cardiostimulatory response and 4 experimental dogs showed a cardiodepressant response following gastric decompression. Cardioactive substance bioassays correlated well with isovolumetric indices in experimental dogs. The variable response in cardioactive substance bioassay observed in experimental dogs was consistent with clinical gastric dilatation-volvulus bioassays which produced a widely variable response ranging from strongly cardiostimulatory to strongly cardiodepressant.

Animals↗
PubMed1983

[Physiologic surgery for anomalies of the cardio-hiatal region].

In 11 years (1971-1981) 1.040 cases of anomalies of the cardio-hiatal sector have been controlled in the Children's Hospital of the Social Security of Barcelona, 101 patients were operated. Surgical indication was based on the following facts: size of the hernia, poor clinical evolution with postural treatment, or infants of more than 2 years who also presented a high gastric acidity or a clearly pathological pHmetry, or, lastly, a social cause. We have used a much more physiological technique than that of Nissen, based on the obtention of a large segment of the abdominal esophagus on which changes of pressure existing in the abdominal and thoracic cavities can act, clearly registered in manometric studies effected before and after operation. The few complications observed in this large series of operated children speak clearly in favour of its necessary diffusion and utilization.

Cardia↗
PubMed1995

Percutaneous gastrostomy guided by ultrasound and fluoroscopy.

Percutaneous gastrostomy, utilizing a dedicated catheterization kit, with a combination of ultrasonographic (US) and fluoroscopic guidance, was carried out in 27 patients. The main indication for gastrostomy was the need for nutritional support in malignant esophageal stricture. After distending the stomach with water via a nasogastric tube, the gastric antrum was punctured under US guidance and a guide wire was inserted, followed by fluoroscopically guided tract dilatation and insertion of a 2.5-mm Cope-loop catheter. In all patients but one (96%) the procedure was successfully completed in one or 2 attempts. Two complications occurred: one case of a small subcutaneous abscess near the puncture site, and one late incident of dislodgement of a catheter without string-loop fixation, which had been inserted at a catheter exchange after 6 weeks. Percutaneous gastrostomy guided by US and fluoroscopy is a safe and efficacious alternative to endoscopic and surgical gastrostomy.

Adult↗
PubMed1994

[Dilatation of stricture of anastomosis after reconstruction of esophagus].

This article reports the experience of the esophagus dilating technique in the treatment of 658 cases of postoperative anastomotic stricture for esophageal cancer and cardiac cancer during the period from May 1983 to May 1993, being delated add up to 3240 times with total effective rate 96.5%, among them 61.6% of the cases less than five, 84.5% of the cases less than ten. Of them, 27 cases (4.1%) had postoperative complications, of which the main ones were esophagus perforation 8 cases (1.2%), hemorrhage of anastomotic stoma 4 cases (0.6%), mediastinitis 1 case (0.2%) and loca trauma 14 cases (2.1%). The operative indication, surgical technique and complication were discussed.

Adult↗
PubMed1976

Benign esophageal strictures.

For the treatment of esophageal strictures caused by reflux, dilation alone is rarely curative, as a reflux is not prevented. Standard antireflux repairs are the 1st procedures to be used whenever possible. If esophageal damage and shortening is more severe, the Collis gastroplasty operation coupled with an antireflux repair is effective, but the selection of patients is important. The gastroplasty should not be used if the stricture cannot be dilated easily or if several previous operations have been performed at the cardia. If the Thal fundic patch operation is used, a skin graft and full fundoplication should be employed as well. The results from a fundoplication left in the chest are encouraging from initial reports. Further follow-up of all 3 of these approaches is required. For patients with the most difficult strictures, especially following multiple previous failed operations, resection of the stricture and intestinal interposition is the operation of choice.

Colon↗
PubMed2005

Cardiac glands hyperplastic polyp of the stomach.

Reported herein is a very rare polyp in the gastric cardia of a 49-year-old man. He was referred because of a polyp detected by upper gastrointestinal examination in an affiliated hospital. Endoscopic examination revealed a polyp-like submucosal tumor. Endoscopic ultrasonography revealed minute cystic dilatations and thickening of the submucosal layer. Accordingly, a preliminary diagnosis of cardiac gland hyperplasia was made. The lesion was removed successfully by snare polypectomy. Observed macroscopically, the polyp was 30 mm in diameter and covered with normal gastric mucosa. Examined histologically, the polyp comprised a hyperplastic submucosal cardiac gland.

Cardia↗
PubMed2005

The place of gastro-jejuno-duodenal interposition following limited esophageal resection.

OBJECTIVE: Although stomach is the best choice for reconstruction after esophagectomy from the viewpoint of safety and ease, an intrathoracic stomach, nevertheless, is a poor long-term substitute. This anatomical configuration abolishes normal antireflux mechanisms and places the acid-excreting stomach subject to biliary reflux, moreover, in an adjacent position to the esophagus within the negative-pressure environment of the thorax. METHODS: Between 1995 and 2002, 27 patients with high-grade neoplasia-as early Barrett's carcinoma-or non-dilatable peptic stricture underwent limited surgical resection of the distal esophagus and esophagogastric junction. In 11 of these cases, the reconstruction was performed with gastro-jejuno-duodenal interposition. The long-term functional results of this specially adapted form of interposition reconstruction have been evaluated. The postoperative follow-up period ranged between 24 and 95 months (mean 68 months). Nine patients (9/11=81.8%) have agreed to undergo endoscopy, radiographic contrast-swallow examination, and 24-h ambulatory esophageal pH and bilirubin monitoring. RESULTS: Three out of nine patients (3/9=33%) demonstrated abnormal levels of esophageal acid exposure during the 24-h study period, whilst none had any evidence of bilirubin exposure in the esophageal remnant. Endoscopy revealed that three patients had reflux esophagitis in the remnant esophagus: Los Angeles A=2, C=1. No stomal or jejunal ulceration at the gastro-jejunal anastomosis could be observed. Histopathologic assessment of the squamous epithelial biopsies demonstrated microscopic evidence of inflammation: minor in two cases, moderate in one and major in one case; however, none of them had evidence of columnar metaplasia in the esophageal remnant at a median of 68 months after surgery. The majority of the patients have been doing well since the operation: 8/9 (88%)=Visick I-II. CONCLUSIONS: Gastro-jejuno-duodenal interposition represents an adequate 'second-best' method of choice if technical difficulties emerge with jejunal or colon interposition following limited resection of the esophagus performed due to early Barett's carcinoma or non-dilatable peptic stricture.

Adult↗
PubMed2002

Watermelon stomach: not only an antral disease.

BACKGROUND: Gastric antral vascular ectasia (GAVE) is a source of GI bleeding. Several associated conditions have been recognized. However, there is little information on the occurrence of ectatic lesions in regions of the stomach other than the antrum, that is, the cardia. Patients in whom a diagnosis of GAVE was made from 1990 to 2000 are presented with an emphasis on the frequency of contemporaneous ectatic lesions in the gastric cardia. METHODS: A diagnosis of GAVE was made in 17 patients. Concurrent disorders were identified. After 1996, all patients with GAVE were systematically examined for ectatic changes in the cardia. RESULTS: Several of the 17 patients had lesions in the cardia, 2 of 9 being identified before 1996 and 5 of 8 after 1996. The most common comorbid conditions were liver (n = 5) and heart disease (n = 4). CONCLUSION: Ectatic lesions in the cardia are common in patients with GAVE. The significance of this finding remains to be investigated.

Adult↗
PubMedDate not supplied

[Crohn's disease of the esophagus. Apropos of a case].

The authors report a case of Crohn's disease of the esophagus, stomach, small intestine, colon and rectum in a 34-year-old patient. The esophagus was affected three months after diagnosis of the ileo-rectal lesion. They discuss clinical and therapeutic aspects of the condition. They stress the value of upper endoscopy with multiple biopsies in providing the diagnosis. Treatment is essentially medical, surgery being restricted to fistulas after failure of medical treatment and parenteral nutrition, and to severe stenoses after failure of endoscopic dilatation.

Adult↗
PubMed2001

Intraglandular necrotic debris in gastric biopsy and surgical specimens.

To clarify whether intraglandular necrotic debris (IND) is a diagnostic clue to noninvasive high-grade neoplasia or invasive neoplasia of the stomach, we reviewed 135 gastric biopsy specimens and 55 surgical materials. Intraglandular necrotic debris is defined as an eosinophilic material with necrotic epithelial fragments within the lumen of a dilated atypical gland. Using the Vienna classification, the incidence of IND in category 4 (noninvasive high-grade neoplasia) and category 5 (invasive neoplasia) was significantly higher than that of category 1 (negative for neoplasia/dysplasia), category 2 (indefinite for neoplasia/dysplasia), and category 3 (noninvasive low-grade neoplasia). The incidence of IND was much higher in category 5 than in category 4 in biopsy specimens. In addition, cases with IND in category 4 in biopsy specimens turned out to be either carcinoma in situ or invasive carcinoma in the surgical specimens. According to the histologic classification of surgically removed invasive carcinoma, moderately differentiated adenocarcinoma showed the highest incidence of IND. Intraglandular necrotic debris was not found in either signet-ring cell carcinoma or mucinous adenocarcinoma. Our results indicate that IND in biopsy specimens is a diagnostic clue to noninvasive high-grade neoplasia or invasive carcinoma, and the origin of IND may be associated with necrotic atypical epithelium.

Adenocarcinoma↗
PubMed1997

Intermittent positive ventilation through a laryngeal mask in children: does it cause gastric dilatation?

After obtaining Ethics Committee approval and informed consent, sixty children, ASA Grade 1 or 2 and aged six months to ten years, were randomly allocated to receive intermittent positive pressure ventilation through either a laryngeal mask or a tracheal tube. Inflation pressures were maintained below 20 cm H2O, and gas aspirated from the stomach via an orogastric tube over a one h period. No large volumes were aspirated and no differences were detected between the groups. We conclude that healthy children over the age of six months can be safely ventilated through the laryngeal mask airway without gastric distension.

Air↗
PubMed1996

Cholecystokinin-A receptors modulate gastric sensory and motor responses to gastric distension and duodenal lipid.

BACKGROUND & AIMS: The combination of duodenal lipid and gastric distention induces meal-like fullness followed by nausea in healthy subjects. The aim of this study was to assess the role of cholecystokinin (CCK) A receptors in these changes using a CCK-A antagonist loxiglumide. METHODS: Twelve healthy subjects were studied on four occasions, during which either 0.9% saline or 20% Intralipid was infused intraduodenally on two occasions each (1 mL/min) while the proximal stomach was distended with air (100 mL/min). During each duodenal infusion, subjects received intravenous loxiglumide (10 mg.kg-1.h-1) on 1 day and placebo on the other. Intragastric pressure changes were recorded, and the subjects reported gastric sensations (fullness, nausea). RESULTS: Loxiglumide did not influence gastric motility or sensitivity during duodenal saline infusion. Duodenal lipid reduced gastric tonic and phasic pressure activity during distensions and induced meal-like fullness and nausea; sensations were reported at similar volumes but lower intragastric pressures (P < 0.001 vs. saline). Loxiglumide partially restored gastric tonic and phasic activity during lipid infusion, reduced the occurrence of meal-like fullness and nausea, and increased the pressures at which sensations were reported (P < 0.001 vs. placebo). CONCLUSIONS: CCK-A receptors are involved in the induction of meal-like fullness and nausea associated with intraduodenal lipid and gastric distention.

Adult↗
PubMed1985

5-Carboxamide tryptamine, a compound with high affinity for 5-hydroxytryptamine1 binding sites, dilates arterioles and constricts arteriovenous anastomoses.

The effects of 5-carboxamide tryptamine, which activates non-5-hydroxytryptamine2-'atypical' receptors for 5-hydroxytryptamine (5-HT) in the dog saphenous vein, was studied on the complete distribution of cardiac output and common carotid blood flow in anaesthetized pigs. The drug was infused for 10 min at the rate of 0.025, 0.1 and 0.4 micrograms kg-1 min-1 either intravenously (cardiac output distribution) or intra-arterially (carotid distribution). 5-Carboxamide tryptamine decreased arterial blood pressure due to a reduction of cardiac output. This reduction was confined to its arteriovenous anastomotic component; the component used for the tissue perfusion (nutrient part) in fact increased. Similar changes were observed in the carotid blood flow distribution. Vasodilation was observed in several tissues, but the skin, ears and stomach responded most prominently. The effects of 5-carboxamide tryptamine on the carotid distribution were not significantly modified by cyproheptadine (1 mg kg-1). It is concluded that, like 5-HT, 5-carboxamide tryptamine constricts arteriovenous anastomoses and dilates arterioles by activating non-5-HT2-'atypical' receptors. These 'atypical' 5-HT receptors appear to be of the 5-HT1 type since both 5-carboxamide tryptamine and BEA 1654, a new piperazine derivative, produced similar vascular effects in the carotid bed of the pig and also showed a high and selective affinity for the 5-HT1 binding sites.

Animals↗