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)

During the past four years three patients have been seen with ischemia of the colon segment following colon interposition. Colon interposition was done for esophageal cancer in two patients and for esophageal stricture following ingestion of lye. Colon ischemia was manifested as early as two weeks in one patient and as late as eight weeks in the others. Colon ischemia presented a frank gangrene with cervical fistula or as dysphagia due to stricture formation. Dysphagia in two patients prompted mechanical dilatation of the colon segment which led to perforation in both cases. All three patients had empyemas. The management of these patients includes proper diagnosis, drainage of abscesses and antibiotic treatment, hyperalimentation and visceral arteriography to delineate the residual colon for reinterposition. Two of the three patients in the series are long-term survivors and are well.
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PMID:Management of colon ischemia following colon interposition for esophageal substitution. 9 13

Ten patients with aneurysm of an aberrant right subclavian artery have been previously reported. Dysphagia is not commonly part of the initial symptomatology, and the diagnosis is usually established by chest roentgenogram, esophagogram, and aortography. If operative intervention is planned, adequate preparation for bypass and thoracic aortic grafting should be made since the aneurysm may also involve the descending thoracic aorta at the site of origin of the aberrant subclavian artery. Since both ischemia of the involved arm and the subclavian steal syndrome may occur after division of the origin of the subclavian artery, resotration of arterial flow in the distal subclavian artery is preferred. An additional patient is reported in whom right subclavian-to-carotid artery anastomosis was used after the subclavian artery aneurysm was removed.
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PMID:Aberrant right subclavian artery aneurysm. 112 66

In 26 patients with carcinoma of the esophagus or gastroesophageal junction, intestinal interposition was performed in post-resection reconstruction, using left colon in 21 cases, right colon in one and a long jejunal segment in four cases. The tumor involved the gastric cardia in 16 patients with colonic interposition and five underwent palliative resection. Infectious pulmonary and abdominal complications were common. Three patients required reoperation, for empyema, ischemic colonic segment and subphrenic abscess, respectively. Ischemia of the interposed segment occurred in two patients, necessitating removal of the segment in one. There was no anastomotic dehiscence and no tumor in the margins of the resected tissue. The 30-day postoperative mortality was 1/22 and the mean postoperative hospital stay 24 days, with 11 patients discharged directly to their homes. The functional results 6 months postoperatively were favorable in most survivors, and only three complained of dysphagia.
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PMID:Colonic interposition for reconstruction after resection of cancer in the esophagus and gastroesophageal junction. 167 28

Nissen's fundal plication is acknowledged as the most effective procedure to suppress gastroesophageal reflux. It entails some morbidity (dysphagia, gas bloat syndrome), in which obstruction is the least frequently evoked but most severe risk. We report about 6 cases (4 children and 2 adults). The 4 children had been operated 3 times during the first few months of life, and their reflux was secondary to the cure of atresia of the esophagus in 2 cases, and caused severe apneas in 1 case, a former premature infant. In three cases, the obstruction was complicated within a few hours by intestinal ischemia causing death. In one case, the emergent insertion of a gastric tube allowed the decompression of the digestive tract and second surgery; the obstruction recurred 2 months later, with no postoperative complications. Two adults (aged 64 and 66) presented with gastric perforation 7 days and 9 months after fundal pliction; one of them died. These cases show how serious these obstructions are (4 deaths/6 cases). The emergent measure in such cases consists of inserting a gastric tube, although which may be impossible (1 case). The patients and their parents must be informed of this risk of complication and of its expressions. Prevention is based on a strictly submesocolic surgical approach, without any exposure of the small bowel.
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PMID:[Intestinal obstruction after Nissen's fundo-plication]. 180 60

Symptoms compatible with vertebrobasilar ischemia have been reported in patients with unilateral or bilateral carotid occlusive disease. Intracranial steal phenomena have been proposed to explain the symptoms. In a review of 54 patients with angiographically documented severe bilateral carotid stenosis (less than or equal to 2 mm residual lumen) or occlusion, eight had symptoms suggesting vertebrobasilar insufficiency. Five patients were identified retrospectively, and the other three were evaluated prospectively. Symptoms included various combinations of hemodynamically mediated, transient bilateral motor, sensory, or visual impairment. Dysarthria, dysphagia, and diplopia were generally absent. Each patient also described additional symptoms compatible with transient hemispheric or retinal ischemia. The anatomic regions subserving the bilateral vertebrobasilar-like symptoms could be correlated with angiographically estimated arterial border zones in both hemispheres and may thus represent bilateral hemispheric border zone ischemia rather than brain stem ischemia. An intracranial steal need not be invoked.
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PMID:The syndrome of bilateral hemispheric border zone ischemia. 226 72

From December 1983 through December 1988, 200 cases of total gastrectomy were performed in Chang Gung Memorial Hospital. The esophagojejunostomy was performed with EEA staplers in 196 cases, and with hand suture in 4 cases. Twelve cases developed anastomotic stricture after the operation. All of these 12 anastomoses were done with EEA 28 mm staplers. Four of the 12 patients received no further treatment either because the symptoms were mild or because of development of carcinomatosis. Six patients received endoscopic YAG laser treatment, only 2 had good results. Four Patients received balloon dilatation, 2 of them had good results, 4 patients received surgical intervention after failure of the balloon dilatation or YAG laser treatment. Of the 4 patients who underwent surgery, the thoracoabdominal approach was used in 3, and a thoracotomy in 1. Three patients received side to side esophagojejunostomy to bypass the stricture site. In the remaining patient, stricture was excised and a new end to end anastomosis was done with hand sutures. All of these 4 patients had good results after the operation. There are many possible mechanisms of the development of anastomotic stricture. Anastomotic leakage, technical error, lack of mucosa-to-mucosa apposition, size of the EEA stapler and tissue ischemia all have been regarded as the possible causes of anastomotic stricture. Once the esophagojejunal anastomosis stricture occurs, treatment should be done to relieve dysphagia. From the results of our patients, endoscopic YAG laser is not a satisfactory treatment for anastomotic stricture.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The treatment of esophagojejunal anastomotic stricture after total gastrectomy]. 262 Feb 85

A patient was referred by Zone Cardiology due to the absence of heart disease in spite of a history suggestive of coronary ischemia and occasional dysphagia. We performed EDA and encountered a submucous mass that was depressible by the endoscope and pulsatile. Biopsy was not performed, but PA-lateral X-ray disclosed a large aortic aneurysm that was later confirmed by CAT.
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PMID:[Esophageal pseudomotor]. 276 44

Aneurysms arising from an aberrant subclavian artery represent a seldom but dangerous condition, which can be treated successfully when appropriately diagnosed. From 37 patients described in the literature most presented a mediastinal mass and had symptoms like dysphagia, dyspnoe or chest pain. Diagnosis is today possible by contrast-enhanced computed tomography. The aneurysm should be resected to prevent lethal rupture. Left thoracotomy seems to be the appropriate approach in most cases. Reestablishment of blood flow to the right subclavian artery seems not necessary and may be done if ischemia develops in a second procedure by subclavian transposition to the common carotid artery. The case of a 74-year-old women who had resection of an aneurysm in an aberrant subclavian artery is described together with a review of the literature and discussion of the surgical management.
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PMID:[Aneurysm of the arteria lusoria. Case report and review of the literature]. 306 Mar 23

Aneurysms arising in an aberrant subclavian artery are rare but constitute a potentially lethal condition that can be treated successfully when appropriately identified. Virtually all patients have a superior mediastinal mass that may be asymptomatic, but usually patients have symptoms of dysphagia, chest pain, or shortness of breath. An accurate diagnosis can now be made noninvasively with computerized tomography. The presence of an aneurysm of an anomalous subclavian artery is an indication for surgical resection. Resection of the aneurysm may be approached through either a right or left thoracotomy. Reestablishment of continuity of flow to the right subclavian artery decreases the risk of ischemia of the extremities and prevents development of the subclavian steal syndrome. Reestablishment of flow to the right subclavian artery is more easily performed through a right thoracotomy incision but this approach limits control of the aorta at a possibly treacherous connection between aorta and aneurysm. In such circumstances a preliminary extra-anatomic reconstitution of flow to the right subclavian artery followed by a left thoracotomy may be preferable. A 67-year-old woman is described who had resection and grafting of an aneurysm in an aberrant right subclavian artery together with a review of the literature and a discussion of problems in the management of patients with this condition.
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PMID:Aneurysm of aberrant subclavian artery with a review of the literature. 389 54

Isobutyl-2 cyanoacrylate (IBC) was used to embolize the bronchial arteries of 14 patients with severe hemoptysis. The site of bleeding was supplied by a bronchial artery from the aorta in 11 cases and from a right bronchointercostal trunk in three. IBC was injected after previous reduction of the blood flow in the artery by embolization with particles of dura mater. In all cases, bleeding stopped immediately after occlusion and no spinal cord complications were observed. The results indicate that IBC may be a valuable occluding agent in severe hemoptysis, since it produced virtually permanent occlusion of both the distal and proximal parts of the artery. In 13 patients, bleeding did not recur throughout follow-up periods of 2-17 months. In one patient, it recurred 12 months after embolization but stopped after occlusion of another bronchial artery with IBC. It should be noted, however, that immediately after embolization, five patients experienced violent transient retrosternal burning, and one patient experienced dysphagia and fever for 2 days. Since mediastinal ischemia cannot always be avoided, this procedure must be reserved for cases of severe hemoptysis for which surgical treatment is contraindicated.
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PMID:Bronchial artery occlusion for severe hemoptysis: use of isobutyl-2 cyanoacrylate. 660 May 35


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