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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The state of the esophagus was studied in 60 patients with endogenous hypercorticism (2 with corticosteroma, 58 with Icenko-Cushing disease). The purpose was to reveal the nature and frequency of esophageal lesions and peculiarities of their clinical symptoms. X-ray and endoscopic methods were used. Functional and organic esophageal changes were shown to be rather common in patients with excess of body glucocorticoids: hypomotor dyskinesia was noted in 27% of the patients, cardial insufficiency in 13%, cardial hernia of the esophageal orifice of the diaphragm in 28%, reflux-esophagitis in 43%. Cardial hernia and esophagitis in such patients are often characterized by weak clinical symptoms masked by other signs of severe endocrine pathology. They can be also symptomless making their early diagnosis difficult. However these esophageal diseases are fraught with danger and life threatening complications: ulcerations, perforations, esophageal hemorrhages aggravating a course of the main disease. These patients need appropriate therapy to avoid complications.
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PMID:[Esophageal lesions in Cushing's syndrome and corticosteroma]. 336 6

Cushing's syndrome in pregnancy is a rare phenomenon and there is limited literature on its management. Cushing's disease in pregnancy is even less common and there is little guidance to help in the treatment for this patient group. Diagnosis of Cushing's syndrome in pregnancy is often delayed due to overlap of symptoms. In addition, there are no validated diagnostic tests or parameters documented. We present a case of a 30-year-old woman presenting to the antenatal clinic at 13 weeks of pregnancy with high suspicion of Cushing's disease. Her 21-week fetal scan showed a congenital diaphragmatic hernia and she underwent pituitary magnetic resonance imaging, which confirm Cushing's disease. She successfully underwent transsphenoidal adenomectomy with histology confirming a corticotroph adenoma. Tests following transsphenoidal surgery confirmed remission of Cushing's disease and she underwent an emergency caesarean section at 38 weeks. Unfortunately, her baby died from complications associated with the congenital abnormality 36 hours after birth. The patient remains in remission following delivery. To date, there have been no reported cases of congenital diaphragmatic hernia associated with Cushing's disease in pregnancy. In addition, we believe that this is only the eighth reported patient to have undergone successful transsphenoidal surgery for Cushing's disease in pregnancy.
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PMID:Surgery for Cushing's disease in pregnancy: our experience and a literature review. 3028 51