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

Literature dealing with the management of undilatable oesophageal strictures in Africa is either scanty or non-existent. This report reviews 73 cases of adult undilatable corrosive strictures treated by oesophageal replacement at the University of Nigeria Teaching Hospital (UNTH) Enugu over a 5-year period (March 1986 to February 1991). Almost all the cases were suicidal or parasuicidal. All the patients had colon transplants; the right colon was used in 68 patients while the left colon was used in five patients. The age range was 13 to 48 years with a mean of 26 years. There were 65 males and 8 females. Four patients died in the postoperative period, earlier on in our surgical experience, a mortality of 5%. Of the 69 survivors, 62 patients (90%) experienced no dysphagia after 6-9 months of follow-up. Four patients (6%) swallowed with some difficulty while three patients who could not swallow at all 6 months after surgery underwent further surgery, the strictured upper part of the transplants being replaced with myocutaneous tube grafts after which two patients were able to swallow. Major postoperative complications were proximal anastomotic leak 49% (34 patients) of survivors, wound sepsis 25% (17 patients), tension pneumothorax 7% (five patients), colon graft necrosis 4% (three patients), and Ascaris upper intestinal obstruction 4% (three patients). The short and medium term results after colon transplant for oesophageal corrosive strictures are good. Our experience emphasizes the fact that these patients are from the very low social class, usually ignorant and most default at the follow-up clinics, once they start swallowing.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Oesophageal replacement in adult Nigerians with corrosive oesophageal strictures. 827 37

Tracheobronchial ruptures are rare but potentially lifethreatening events. We report on the case of a 34-year-old suicidal unrestrained car driver, who developed subcutaneous and mediastinal emphysema and right-sided haematothorax following blunt thoracic trauma. Fibreoptical inspection of the tracheobronchial system revealed a rupture (approximately 2 cm in length) of the pars membranacea of the trachea ending shortly above the carina. CT-scan confirmed the diagnosis of mediastinal emphysema, tracheal rupture and, in addition, left-sided pulmonary contusion. A repair of the tracheal tear was performed by right-sided thoracotomy using a double-lumen tube. The left-sided double-lumen tube was used postoperatively to achieve respirator ventilation with low pressure on the tracheal lumen and on the suture of the tracheal tear. On the other hand, sufficient airway pressure with PEEP for the left lung showing contusion could be provided, using the endobronchial tube. The postperative course was without complications. The patient was on respiratory support for three days due to his-pulmonary contusion. Following final endoscopic control of the trachea he was discharged from the ICU one week after the trauma. The clinical and radiological signs of tracheobronchial ruptures are discussed (respiratory distress, haemoptysis, cyanosis, localised pain, hoarseness, coughing, dysphagia, stridor, subcutaneous emphysema and pneumothorax, tension pneumothorax, mediastinal emphysema). Fibreoptic bronchoscopy is the present gold standard for confirming the diagnosis. The surgical and anaesthesiological approach to the management of tracheobronchial ruptures is described reviewing the current literature.
 ...
PMID:[Diagnosis and therapy of tracheal rupture after blunt thoracic trauma]. 928 31

Intrathoracic gastric herniation after laparoscopic antireflux surgery is a rare but well known phenomenon. It may occur during the early and late postoperative period. We report on a patient with early onset of dysphagia after surgery due to a tight wrap. Subsequent vomiting and dysphagia increased due to a gastric herniation. After gastroscopy and bougienage, tension pneumothorax developed. The context and relationships are illustrated and discussed referring to the current literature.
 ...
PMID:[Dysphagia and dyspnea after laparoscopic fundoplication]. 1744 2

We present a case of a gentleman in his 70s with extensive subcutaneous emphysema. Usually self-limiting, subcutaneous emphysema around the thoracic inlet can rarely lead to airway and cardiovascular compromise by compression of structures in the neck. This patient presented with a large pneumothorax on a background of chronic obstructive pulmonary disease (COPD). This was initially treated with an intrapleural chest drain. However, after removal of this drain, the patient developed subcutaneous emphysema and later signs of tension pneumothorax. Further intrapleural chest drains were required. One of these chest drains produced a broncho-subcutaneous fistula, which contributed to extensive subcutaneous emphysema. He developed symptoms of dysphonia and dysphagia. A subcutaneous drain was inserted for palliation of his symptoms and to improve his quality of life. His symptoms improved significantly after insertion of this subcutaneous drain. There are only a handful of case reports published on interventions to relieve subcutaneous emphysema.
...
PMID:Management of extensive subcutaneous emphysema with a subcutaneous drain. 2547 35