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)

Esophageal malignancy is one of the most aggressive malignancies. Unfortunately, the majority of patients present with incurable disease. Then palliative treatment to relieve dysphagia is the mainstay of treatment. We compared the mortality, procedure-related complications, hospital stay, intervention time, improvement of dysphagia and survival time between esophageal stent and surgery. There were twenty patients who underwent esophageal stent and twenty-three patients underwent surgical treatment. Pretreatment characteristics were similar between the two groups. The mortality between the surgical group and the esophageal stent group was 30.43 per cent (7/23) and 5 per cent (1/20) (p<0.05). The complications in the surgical group included anastomotic leakage 39.13 per cent (9/23), wound dehiscence 4.35 per cent (1/23), small bowel obstruction 4.35 per cent (1/23) and late anastomotic stricture 37.5 per cent (6/16). In the esophageal stent group, the complications were severe chest pain 10 per cent (2/20), stent displacement 10.52 per cent (2/19), stent obstruction from food impaction 15.78 per cent (3/19) and tumor overgrowth leading to stent obstruction 5.26 per cent (1/19). More intervention time and hospital stay (post intervention period and ICU period) was spent in the surgical group (320.43+/-133.84 mins vs 57.5+/-23.98 mins p<0.001, 30.39+/-20.69 days vs 4.9+/-2.61 days p<0.001, 9.79+/-16.64 days vs 0 days p<0.05). The improvement of dysphagia was 1.00+/-1.03 vs 1.75+/-0.72 (p<0.05). Survival between the two groups was not statistically different (p>0.05).
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PMID:Palliative esophageal stent or surgery in advanced esophageal malignancy. 1180 54

Except in case of bowel obstruction or intestinal failure, nutritional support should be performed by oral or enteral route. In hospitalised patients, the decision of nutritional support depends on both nutritional state and spontaneous oral intake. Dietetic support can use energy enriched food and oral supplement. Enteral nutrition can be proposed in case of failure of dietetic support or at once in case of severe malnutrition or dysphagia. An early start and a good technique are conditions in order to improve outcome of patients.
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PMID:[Treatment of malnutrition: dietetic support and enteral nutrition]. 1268 59

Gastrointestinal metastasis from lung cancer is exceptional and generally asymptomatic. Other secondary localizations are often present. Metastastic dissemination may involve any portion of the gastrointestinal tract. Clinical expression is variable: dysphagia, anemia, bowel obstruction, peritonitis. Surgical treatment may be indicated in selected patients. We describe the cases of two patients who developed obstruction of the small bowel due to metastases from squamous-cell lung cancer. Bowel obstruction was in the inaugural sign in the first patient. Mesenteric metastasis was associated in the second patient.
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PMID:[Metastatic obstruction of the small bowel revealing or complicating squamous-cell lung cancer. Two cases and a review of the literature]. 1313 Feb 3

The use of self-expanding metallic stents (SEMS) as esophageal endoprosthesis represents an advancement in the palliation of dysphagia from unresectable esophageal carcinoma. However, the problem of stent migration persists. Although most migrated stents have a benign outcome, complications do occur. Rare reports of intestinal obstruction have been confined to the stiff plastic and stainless-steel stents. We report the first case of intestinal obstruction secondary to the pliable Nitinol SEMS (Ultraflex) migration.
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PMID:A rare life-threatening complication of migrated nitinol self-expanding metallic stent (Ultraflex). 1510 27

Malignant melanoma is one of the most common malignancies to metastasize to the gastrointestinal (GI) tract. Metastases to the GI tract can present at the time of primary diagnosis or decades later as the first sign of recurrence. Symptoms may include abdominal pain, dysphagia, small bowel obstruction, hematemesis, and melena. We report 2 cases of malignant melanoma metastatic to the GI tract, followed by a review of the literature. The first case is a 72-year-old man who underwent resection of superficial spreading melanoma on his back 13 years previously who presented with dysphagia. A biopsy specimen of a mucosal fold in a gastric fundus noted during endoscopy was taken and revealed metastatic malignant melanoma, which was resected 1 month later. Three weeks later, the patient was found to have an ulcerated jejunal metastatic melanoma mass, which was also resected. The second case is a 63-year-old man with an ocular melanoma involving the chorold of the left eye that had been diagnosed 4 years previously, which had been excised several times, who presented with anorexia, dizziness, and fatigue. He was found to have cerebellar and stomach metastases. He underwent adjuvant radiation therapy, chemotherapy, and surgical resection of the gastric melanoma metastasis. In patients with a history of melanoma, a high index of suspicion for metastasis must be maintained if they present with seemingly unrelated symptoms. Diagnosis requires careful inspection of the mucosa for metastatic lesions and biopsy with special immunohistochemical stains. Management may include surgical resection, chemotherapy, immunotherapy, observation, or enrollment in clinical trials. Prognosis is poor, with a median survival of 4 to 6 months.
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PMID:Metastatic malignant melanoma of the gastrointestinal tract. 1661 May 71

Insertion of a self-expanding metal stent is commonly used to palliate dysphagia secondary to oesophageal carcinoma. Displacement of the stent itself is a recognized complication which can result in perforation of the upper gastrointestinal tract. We report the first case of bowel obstruction and perforation resulting from the olive of the deployment system. This was probably due to peritoneal deposits on the small intestine obstructing passage of the olive.
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PMID:An unusual complication of oesophageal stent deployment. 1792 2

Metastatic breast cancer involving the hepatobiliary tract or ascites secondary to peritoneal carcinomatosis has been well described. Luminal gastrointestinal tract involvement is less common and recognition of the range of possible presentations is important for early and accurate diagnosis and treatment. We report 6 patients with a variety of presentations of metastatic breast cancer of the luminal gastrointestinal tract. These include oropharyngeal and esophageal involvement presenting as dysphagia with one case of pseudoachalasia, a linitis plastica-like picture with gastric narrowing and thickened folds, small bowel obstruction and multiple strictures mimicking Crohn's disease, and a colonic neoplasm presenting with obstruction. Lobular carcinoma, representing only 10% of breast cancers is more likely to metastasize to the gastrointestinal tract. These patients presented with gastrointestinal manifestations after an average of 9.5 years and as long as 20 years from initial diagnosis of breast cancer. Given the increased survival of breast cancer patients with current therapeutic regimes, more unusual presentations of metastatic disease, including involvement of the gastrointestinal tract can be anticipated.
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PMID:Metastatic breast cancer to the gastrointestinal tract: a case series and review of the literature. 1703

Significant weight loss, a body mass index of less than 18.5, hypoalbuminemia, and a deficiency in specific nutrients are major criteria. Depending on the underlying diagnosis, maldigestion, malabsorption, catabolism, dysphagia, anorexia and intestinal obstruction are possible causes of malnutrition. In the majority of cases, malnutrition is associated with a poorer prognosis, a reduced general health status, and poorer quality of life. This means that in addition to treatment of the underlying disease, specific nutritional support, preferably by the enteral route, with the aim of providing an adequate supply of nutrients and improving the patient's general nutritional status is of importance.
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PMID:[Malnutrition in gastroenterological diseases]. 1767 6

Far-advanced cancer patients often have gastrointestinal symptoms. Many of these symptoms are reversible. In this report the causes and treatment options of the most frequent symptoms are demonstrated. Symptoms are dry mouth, anorexia, dysphagia, nausea and vomiting, bowel obstruction, constipation, gall bladder obstruction and bleeding. Focus is on the most challenging symptoms in daily practice, which are nausea, vomiting and bowel obstruction. Ethical dilemmas are often involved. Randomised trials are needed since evidence for treatment is sparse.
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PMID:[Symptomatic alleviation of gastrointestinal symptoms]. 1802 44

Acute pandysautonomia is a rare acute autonomic neuropathy that mainly affects young women. We report a case of idiopathic acute pandysautonomia associated with an esophageal achalasia in a 30-year-old woman. The clinical features were inaugural dysphagia followed by signs of parasympathetic failure of the entire digestive tract, bladder and pupils. Twenty-four hours of electrocardiographic recording showed involvement of sympathetic adrenergic nerves. Esophageal achalasia was patent on esophageal manometry. Upper digestive tract motility was first involved and then extended to the entire digestive tract with intestinal obstruction, which required emergency ileostomy. Recovery of autonomic functions was slow. After 16 months, dysphagia and gut paresis improved and digestive continuity was restored. In case of subacute intestinal pseudo-obstruction associated with autonomic dysfunction, acute pandysautonomia should be suspected. In our report, the association with esophageal achalasia is uncommon.
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PMID:[Slowly regressing acute pandysautonomia associated with esophageal achalasia: a case report]. 1840 50


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