Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endoscopic esophageal variceal sclerotherapy was performed in 301 patients with portal hypertension (emergency, 72 and elective, 229) using 3% aqueous phenol as sclerosant. The cause of portal hypertension was cirrhosis of the liver in 189 patients (Child's class A-48, B-66, and C-75), extrahepatic portal venous obstruction (EHPVO) in 90, and non-cirrhotic portal fibrosis in 22 patients. In the emergency group, active bleeding was controlled in 87% of cases. Re-bleeding occurred in 101 of 290 (35%) surviving patients. Obliteration of varices was achieved in 228 (84%) patients, with a mean of 5.14 +/- 2.27 sclerotherapy sessions. Of 301 patients, 29 (9.6%) had an early in-hospital mortality (30.5% in emergency and 3% in elective group), with 16 deaths due to variceal bleeding. Of the remaining 272 patients, 40 (15%) died during follow-up, of which only 11 died of variceal bleeding. Complications, such as superficial ulcers, dysphagia, and strictures, were observed in 14%, 7% of emergency, and 3% of elective patients. None of the patients developed systemic toxicity. In conclusion, 3% aqueous phenol is an effective, safe, and economical sclerosant for esophageal variceal sclerotherapy.
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PMID:Endoscopic esophageal variceal sclerotherapy using 3% aqueous phenol. 156 12

We have evaluated 169 patients with portal hypertension receiving endoscopic variceal sclerotherapy in order to assess the predisposing factors, clinical profile, and treatment response of sclerotherapy-induced esophageal strictures. Of the 129 patients included in the final analysis, 20 (15.5%) developed persistent esophageal stricture. No significant difference was found with respect to age, nature of sclerosant (absolute alcohol, ethanolamine oleate, or sodium tetradecyl sulfate), etiology of portal hypertension, Child's class, initial variceal score, or intensity of sclerotherapy schedule between the patients who developed strictures and those who did not. However, female sex (P less than 0.01) and persistent esophageal ulceration (P less than 0.05) did predispose to stricture formation. Sclerotherapy-induced strictures presented with a variable grade of dysphagia, were always solitary, and were localized to the lower end of esophagus. Most of these could be dilated rapidly using Eder-Puestow metal olives (3.15 +/- 0.80 dilatation sessions per patient). Stricture formation did interrupt an effective sclerotherapy program but only temporarily, and successful variceal obliteration could be obtained after stricture dilatation.
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PMID:Esophageal strictures following endoscopic variceal sclerotherapy. Antecedents, clinical profile, and management. 173 57

Felson and Lessure 1964 (1) described varicosities involving the upper third of the esophagus in patients without portal hypertension. Several etiological factors causing these "downhill" varices, e.g. bronchogenic carcinoma, retrosternal thyroid adenoma or mediastinal fibrosis, have been described. Since September 1989 ectatic esophageal veins or "downhill" varices were diagnosed in nine patients with dysphagia and/or non cardiac chest pain. Intrathoracic masses as a possible cause of "downhill" varices could not be diagnosed in any of these patients. Endoscopy of the upper gastro-intestinal tract revealed spiral esophageal contractions as a potential sign of a esophageal motor disorder in seven patients. By means of esophageal manometry "nutcracker"-esophagus was seen in two patients and diffuse esophageal spasm in three patients. On the basis of these findings primary esophageal motor disorders should be considered as a possible cause of ectatic veins in the proximal esophagus and "downhill" varices.
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PMID:[Circumscribed venous ectasia of the upper esophagus and "downhill" varices in primary disorders of esophageal motility]. 195 42

The indications for and findings in 431 consecutive patients who had upper gastrointestinal endoscopy in Zaria from June 1978 to August 1982 are reviewed. The major indications were dyspepsia (78.1%), upper gastro-intestinal bleeding (12.1%) and portal hypertension (4.2%). Other indications were persistent vomiting, dysphagia and abdominal masses. The mean age of the patients was 32 years. The male: female ratio (3:1) was not different from that in the hospital population. There were no abnormal findings in 32.7%. 26.6% had duodenal ulcers. Duodenitis was noted in 24.8%, oesophageal varices in 6.3%, gastritis in 6.3% and hiatus hernia in 4.6%. In those who presented with upper-gastrointestinal haemorrhage, oesophageal varices (34.6%) and peptic ulcer (17.3%) were the commonest findings. Complication seen commonly were soreness in the throat and thrombophlebitis at the site of valium injection. One death was recorded from the procedure over the period.
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PMID:Upper gastrointestinal endoscopy in Zaria, northern Nigeria. 208 5

Esophageal variceal ulcers have been held responsible for most postsclerotherapy complaints. To investigate a possible relation between these ulcers and symptoms, we followed for 4 weeks 40 patients with portal hypertension who had received a single course of intravariceal sclerotherapy. All 40 patients were found to have mucosal variceal ulcers on the day after sclerotherapy. One or more symptoms were given by 26 (65%) patients; dysphagia by 53% (mean duration 4.6 +/- 2.2 days), retrosternal pain by 28% (mean duration 3.0 +/- 2.5 days), and fever by 15% (mean duration 2.1 +/- 0.4 days). A gastric variceal ulcer was responsible for bleeding in one (2.2%) patient. We found no correlation between the occurrence and duration of symptoms and the presence of variceal ulcers. While symptoms were transient, ulcers persisted for several days to weeks in most patients. Patients who had received a higher amount of sclerosant developed larger ulcers (greater than 1 cm) with more symptoms and healing was more delayed than in those who had received lesser amounts and developed smaller ulcers (less than 1 cm). In patients with a serum albumin level greater than 3.0 g/dl, ulcers healed more often than in those with a less than 3.0 g/dl albumin (72 versus 18%, p less than 0.05). Development of mucosal ulcers is a natural consequence of intravariceal sclerotherapy and it appears unrelated to symptoms. The chemical nature and the volume of the injected sclerosant are probably responsible for the symptoms after sclerotherapy. Further, postsclerotherapy ulcers heal spontaneously, more often in patients with good nutritional status.
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PMID:Ulcers after intravariceal sclerotherapy: correlation of symptoms and factors affecting healing. 236 93

In 1984 we started a prospective controlled trial comparing endoscopic sclerotherapy (ES) with the distal splenorenal shunt (DSRS) in the elective treatment of variceal hemorrhage in cirrhotic patients. The study population included 40 patients with cirrhosis and portal hypertension referred to our department from October 1984 to March 1988. These patients were drawn from a pool of 173 patients who underwent either elective surgery or endoscopic sclerotherapy during this time. Patients were assigned to one of the two groups according to a random-number table: 20 to DSRS and 20 to ES. During the postoperative period, no DSRS patient died, while one ES patient died of uncontrolled hemorrhage. One DSRS patient had mild recurrent variceal hemorrhage despite an angiographically patent DSRS. Four ES patients suffered at least one episode of gastrointestinal bleeding: two from varices and two from esophageal ulcerations. Five ES patients developed transitory dysphagia. Long-term follow-up was complete in all patients. Two-year survival rates for shunt (95%) and ES (90%) groups were similar. One DSRS patient rebled from duodenal ulcer, while three ES patients had recurrent bleeding from esophagogastric sources (two from varices and one from hypertensive gastropathy). One DSRS and two ES patients have evolved a mild chronic encephalopathy; four DSRS and two ES patients suffered at least one episode of acute encephalopathy. Two ES patients had esophageal stenoses, which were successfully dilated. Preliminary data from this trial seem to indicate that DSRS, in a subgroup of patients with good liver function and a correct portal-azygos disconnection, more effectively prevents variceal rebleeding than ES. However no significant difference in the survival of the two treatment groups was noted.
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PMID:Distal splenorenal shunt versus endoscopic sclerotherapy in the prevention of variceal rebleeding. First stage of a randomized, controlled trial. 240 92

Diagnostic and therapeutic upper gastrointestinal endoscopy was carried out among 200 children. The procedure proved useful in detecting causes of various upper gastrointestinal problems especially hematemesis and dysphagia. It was also helpful in early detection of esophageal varices in children with suspected portal hypertension. Duodenal biopsies could be obtained in all children being investigated for chronic diarrhea and proved helpful in diagnosing three cases of celiac disease. Fiberoptic endoscopy has a large role to play in pediatric practice and is largely a safe procedure.
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PMID:Upper gastrointestinal endoscopy in children. 275 27

Between February 1984 and September 1987, endoscopic embolization (EE) was performed in 26 patients with esophageal varices. The effects of EE were evaluated with endoscopic findings according to the general rules for recording endoscopic findings on esophageal varices as specified by the Japanese Research Society for Portal Hypertension. 1) When the result was regarded as effective if a patient had Cw, F1, R-C sign (-), Li and Lm or disappearance of varices, the improvement was found in 66.7% for Color, 79.2% for R-C sign, 54.2% for Form and 45.8% for Location after EE. 2) Recurrence of varices was found in 50% of the patients (12/24) and 4 of 12 cases (33.3%) had rebleeding. 3) When the endoscopic findings before and after EE were compared between relapsed and unrelapsed cases, relapsed patients had more unfavorable endoscopic findings, furthermore, the extent of improvements was also worse than that of unrelapsed cases. 4) As complications, slight fever, dysphagia and epigastric pain were found in most cases, however, all were cured conservatively. In conclusion, EE is useful and safety tool for the improvement of endoscopic findings of the patients with esophageal varices.
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PMID:[Assessment of endoscopic embolization in the management of esophageal varices]. 275 92

We performed endoscopic sclerotherapy of esophageal varices (ESEV) as an outpatient procedure in a private setting in patients with portal hypertension and a least one previous episode of variceal hemorrhage. Twenty-six stable cirrhotic patients (child's class A, 11 patients; class B, 10 patients; class C, 5 patients) underwent 103 outpatient sessions of ESEV. There were two episodes of post-sclerotherapy bleeding (1.9% of total sessions) requiring hospitalisation. Fever (2.9%), dysphagia (6.8%), chest pains (14.6%) and one episode (1%) of respiratory depression due to sedation were also noted, but were managed with simple measures. One of 26 patients developed esophageal stricture. These preliminary results suggest that ESEV can be performed as a relatively safe ambulatory procedure.
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PMID:[Outpatient sclerotherapy of esophageal varices: preliminary results]. 322 99

Of 309 patients with portal hypertension, gastric varices were found in 48 (16 per cent). While the majority (88 per cent) of the patients had gastric varices in association with oesophageal varices, 6 (12 per cent) patients had 'isolated' gastric varices. Gastric varices were seen significantly (P less than 0.01) more often with grade 4 than with grade 3 varices. In 11 (28 per cent) of the 40 patients who completed sclerotherapy for oesophageal varices, gastric varices disappeared concurrently on eradication of oesophageal varices or during the following 6 months. Of the initial five patients with gastric varices who received direct intravariceal injections, four rebled; this technique was therefore replaced by combination (paravariceal + intravariceal) gastric variceal sclerotherapy. Emergency combination sclerotherapy successfully controlled bleeding from gastric varices in six of the eight treated patients. Thirty-two patients entered a programme of elective combination gastric variceal sclerotherapy. Variceal obliteration was achieved in 12 cases (38 per cent) and reduction in size was noted in another 7 patients (22 per cent) after a minimum of four courses. There were 11 (23 per cent) deaths, 8 due to uncontrolled bleeding from gastric varices and 3 due to hepatic coma. The other complications of gastric variceal sclerotherapy were minor and included retrosternal pain, fever and dysphagia. It is concluded that gastric varices often coexist with large oesophageal varices. If they persist for 6 months after eradication of oesophageal varices, a combination of paravariceal and intravariceal sclerotherapy should be attempted for their obliteration.
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PMID:Endoscopic sclerotherapy in the treatment of gastric varices. 326 98


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