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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eleven patients with dysphagia caused by severe esophageal stricture (length 2 to 10 cm) resulting from reflux esophagitis were treated with fibroendoscopic dilation (Eder-Puestow) and Roux-en-Y partial gastrectomy with vagotomy during 10 years (1979 to 1988). There was no operative mortality, but complications developed in three patients: One patient had a mediastinal abscess demanding thoracotomy as a result of esophageal perforation after dilatation; one had postoperative pneumonia; and one patient had ileus. After a mean follow-up of 4 years (range 1 to 10 years) esophagitis healed in all cases, as judged by endoscopy. Eight patients were asymptomatic, but three had slight transient dysphagia. Postoperatively one to eight dilations (average three to four) were needed to relieve dysphagia in the first postoperative year, but later the stricture healed in every case. Postoperative pH measurement was performed in six latest patients and showed complete absence of reflux in all cases. It is concluded that Roux-en-Y partial gastrectomy with vagotomy and endoscopic dilation is an effective, simple, and safe procedure in the management of severe peptic esophageal (acid or alkaline esophagitis) stricture. However, occasional postoperative dilations at the outpatient clinic are often needed in severe cases in the first postoperative year.
J Thorac Cardiovasc Surg 1991 Apr
PMID:Treatment of severe peptic esophageal stricture with Roux-en-Y partial gastrectomy, vagotomy, and endoscopic dilation. A follow-up study. 200 14

Leiomyoma of the esophagus was surgically treated in 15 patients in 1962-1987. Six patients were asymptomatic and nine presented with dysphagia alone or combined with retrosternal pain, vague thoracic discomfort, dyspnea and cough, or palpitations. Barium swallow and esophagoscopy provided the correct diagnosis preoperatively in most cases. Transthoracic enucleation of the tumor was performed via right thoracotomy in nine patients and left thoracotomy in six. The location of tumor was the upper third of the thoracic esophagus in three cases, middle third in six and lower third in six cases. There was no surgical mortality or morbidity. Surgical removal of esophageal leiomyoma thus gave relief of symptoms, with minimal risk and excellent functional outcome.
Scand J Thorac Cardiovasc Surg 1990
PMID:Leiomyoma of the esophagus. 235 88

Traumatic aneurysms of the descending thoracic aorta are a rare but lethal event, having a mortality of 85-90%. Mortality of this population remains high due to the occurrence of aortic rupture. The isthmus of the aorta, just distal to the left subclavian artery is the most frequent site of injury. Acute traumatic injury to the aorta is characterized by hemorrhagic shock symptoms due to the tear in the layers of the aortic wall. Chronic traumatic injury with aneurysmal formation may not surface with symptoms for months or years after initial trauma. Patients who have formed a chronic aneurysm after a trauma incident can experience dysphagia, chest pain, dyspnea, or cough. Surgical repair involves placing a dacron graft in the area of aneurysmal formation. Protection of the lower extremities during the surgical procedure may prevent paraplegia. In a review of ten cases of chronic traumatic aneurysms at Loyola University Medical Center during the past twenty (20) years, all patients underwent surgical repair. There was no incidence of paraplegia. Post-operative nursing care focuses on monitoring hemodynamic stability, preventing respiratory complications and controlling pain.
Prog Cardiovasc Nurs
PMID:Traumatic descending thoracic aneurysms: discussion and nursing care. 236 14

Twenty-six cases of leiomyoma of the esophagus, presenting at four centers of Thoracic Surgery were reviewed. Dysphagia was a presenting symptom in 42% but was the only symptom in 15%. Sixty-two percent of patients presented with dyspepsia and 50% had other upper gastro-intestinal tract disorders. Half the lesions were identified correctly on contrast radiography and seen at endoscopy. Tumors were more or less equally found in the lower and middle thirds of the esophagus and varied in size from 2 cm to 13 cm in diameter. All were removed, 88% by enucleation, but the 3 patients who had esophageal resection all developed postoperative reflux esophagitis. Leiomyomas may cause no important symptoms and do not always cause dysphagia even when large. If treated, they should be enucleated.
Thorac Cardiovasc Surg 1986 Jun
PMID:Leiomyoma of the esophagus. 242 36

One-hundred patients treated with oesophageal intubation for stricture-forming inoperable oesophago-gastric malignancies during the years 1972 to 1983 were analyzed. Fifteen tubes were endoscopically positioned, the rest by thoracotomy or laparotomy. Seven patients died from causes related to the intubation, the causes of death being perforation (2), mediastinitis (3) or aortic erosion (2). Mean survival-time was three months (range one day to 14 months). Nineteen of the most deteriorated patients died within two weeks. Eighty-seven percent of the patients experienced relief of dysphagia. Thus the intended palliation was satisfactory and the results therefore support oesophageal intubation as an alternative to be considered in the treatment of malignancies of the oesophagus and cardia. However, deteriorated patients with extremely short life expectancy might not benefit from the procedure.
Scand J Thorac Cardiovasc Surg 1986
PMID:Palliative intubation in malignant stricture of the oesophagus and cardia. 243 39

During a 12-year period, 77 consecutive patients with unresectable malignant stricture of the oesophagus or cardia were treated with a Celestin tube for relief of dysphagia of varying degree. Pull-through technique and gastrotomy were used for insertion of the tube in 72 patients, and endoscopy in five. One-third of the patients benefited from the operation, i.e. experienced good palliation and no serious complications. The mortality rate was 27%. The authors conclude that all patients with difficulty in swallowing saliva should be intubated, as good palliation was achieved in all such patients. When there is dysphagia for liquid food, insertion of a Celestin tube may be considered, but intubation should not be done when dysphagia is confined to solid foods.
Scand J Thorac Cardiovasc Surg 1987
PMID:Inoperable oesophageal and cardia cancer. Benefits from Celestin intubation. 243 61

A case report of a tuberculous tracheo-oesophageal fistula is described. The patient was successfully treated by antituberculous chemotherapy and a Mousseau-Barbin tube to control dysphagia and choking on deglutition. After 3 months the Mousseau-Barbin tube became displaced and was removed. Closure of the fistula was demonstrated by radiology and endoscopy.
Thorac Cardiovasc Surg 1987 Dec
PMID:Use of a Mousseau-Barbin tube in the management of a tuberculous tracheo-oesophageal fistula. 244 11

Palliative therapy for obstructing esophageal carcinoma is more often necessary than curative surgery. The neodymium:yttrium-aluminum-garnet laser was used for vaporization of obstructing esophageal carcinoma in 18 patients requiring 24 treatments. Three women and 15 men (age range 42 to 87 years) had esophageal carcinoma (seven squamous cell and nine adenocarcinoma). Twelve tumors were at the esophagogastric junction, four at the midesophagus, and two in the cervical esophagus. Lengths varied from 3 to 7 cm. Inoperability was due to diffuse metastases in eight patients, local invasion in five, poor operative risk in one patient, and patient refusal for operative treatment in four patients. Energy use was 1000 to 22,600 J per session (mean 6120 J). Good results were achieved in 16 patients (88.9%): Seven returned to full diet, five to soft diet, and four to full fluids without dysphagia. Four patients required retreatment 1 to 3 months later because of recurrent dysphagia. One patient was not benefited by the treatment and died of carcinomatosis 1 week later. No intraoperative complications occurred. Postoperatively, one patient had laryngeal edema and another had a bronchoesophageal fistula 3 weeks later. The mean survival time is 3 1/2 months. Neodymium:yttrium-aluminum-garnet laser vaporization for obstructing esophageal carcinoma is effective palliation regardless of histologic tumor type. It can be performed under direct vision with a low frequency of postoperative complications.
J Thorac Cardiovasc Surg 1989 Jul
PMID:Neodymium:yttrium-aluminum-garnet laser vaporization for palliation of obstructing esophageal carcinoma. 247 31

Two hundred four infants and children (mean age 13 months) have undergone operation for the relief of tracheoesophageal obstruction resulting from vascular anomalies. One hundred thirteen patients had complete vascular rings (group I), 61 with double aortic arch and 52 with right aortic arch with a left ligamentum. Nine patients had a pulmonary artery sling (group II), 71 had innominate artery compression (group III), and 11 had miscellaneous anomalies (group IV). Patients were admitted with respiratory distress, stridor, apnea, dysphagia, or recurrent respiratory infections. Diagnosis was established by barium esophagogram in group I; barium esophagogram, bronchoscopy, and computed tomography or angiography in group II; bronchoscopy in group III; and barium esophagogram or angiography in group IV. The operative approach was through a left thoracotomy in group I, II and IV (93% of these patients) and through a right thoracotomy for group III (96% of these patients). The operative mortality rate was 4.9% and there were seven late deaths (3.4%). There have been no operative deaths in patients with isolated vascular anomalies in the past 28 years. Follow-up data from 1 month to 20 years (mean 8.5 months) were available on 159 patients; 141 (92%) were essentially free of symptoms, and 12 (8%) had residual respiratory problems. Five of six patients in group II having a lung scan postoperatively had a patent left pulmonary artery. A strong index of suspicion is necessary to avoid the complications of vascular rings in children. Barium swallow is the best single diagnostic technique for patients with complete vascular rings. A bronchoscopic study is required to diagnose innominate artery compression. Angiograms or computed tomographic scans are used to confirm the diagnosis of pulmonary artery sling. Left thoracotomy provides excellent exposure for all vascular rings except the displaced innominate artery, for which a right thoracotomy is the best approach.
J Thorac Cardiovasc Surg 1989 May
PMID:Vascular anomalies causing tracheoesophageal compression. Review of experience in children. 232 34

This report describes 25 patients with reflux-induced cricopharyngeal dysphagia ultimately requiring surgical management. Eighteen patients underwent cricopharyngeal myotomy alone and seven patients required cricopharyngeal myotomy after an antireflux operation failed to correct this symptom. Cricopharyngeal incoordination was demonstrated at manometry in over 90% of patients. Treatment included cricopharyngeal myotomy, which was extended proximally to the pharynx and distally to the intrathoracic esophagus. Results were excellent to satisfactory in 24 of 25 patients. Pathologic examination of the cricopharyngeal muscle demonstrated a wide variety of myopathic degenerative changes. We stress that cricopharyngeal myotomy may be performed even in the presence of reflux without fear of subsequent aspiration.
J Thorac Cardiovasc Surg 1989 Sep
PMID:Myotomy for reflux-induced cricopharyngeal dysphagia. Five-year review. 277 Mar 24


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