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Query: UMLS:C0030193 (pain)
261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Permanent feeding gastrostomies are needed for prolonged alimentation in some patients with foregut obstruction. The usual gastric flap or tube may be limited in patients with previous gastric surgery or with a small stomach. In these patients, interposition of a short, vascularized jejunal segment between the anterior wall of the stomach and the outside may be valuable. Periodic intubation is easy. Tested initially in dogs and then applied to selected patients, we have not seen ulcers, regurgitation, soiling, pain, or other complications.
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PMID:A reversed jejunal segment interposition as feeding gastrostomy. 6 49

An unusual, characteristic case of etiopathic achalasia of the esophagus is reported and the literature is reviewed. This disease has not previously been reported in the dental literature, but is well-known in the medical field. The case report illustrates the salient features of previosuly described achalasia in adults: vague history of asthma with respiratory symptoms of wheezing, obstruction to swallowing, regurgitation, intermittent pain, and peripheral neuritis in a thin patient who claims to be a light eater. The primary concern of the oral surgeon is the management of nutrition. In the case reported, to ingest food. After mobilization of the jaws, the patient could not longer eat the small amounts she could preoperatively. Suspected achalasiactic symptoms should be investigated thoroughly through proper work-up to rule out this disorder before elective surgery is performed. In nonelective cases, the practitioner must be prepared to manage the problems and complications and obtain the proper consultations.
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PMID:Esophageal achalasia after maxillofacial surgery. 28 92

A survey of 102 patients with achalasia of the cardia treated by cardiomyotomy is reported. The technique of operation was unchanged throughout and the patients were followed up for a maximum of 22 years. Only 6 patients (5.8 per cent) developed renewed symptoms of reflux and 7 patients (6.8 per cent) had peptic strictures. Over 80 per cent of the patients had no dysphagia or regurgitation postoperatively, but 61 per cent still complained of achalasic pain. The development of mucosal hernias after cardiomyotomy and the use of drinking times in the assessment of outflow at the cardia are discussed.
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PMID:Results of Heller's operation for achalasia of the cardia. 66 43

18 patients (10 male, 8 female) with an average age of 57 years were operated for diverticula of the esophagus. We found 11 pharyngoesophageal diverticula, 5 parabronchial and 2 epiphrenic diverticula. Major symptoms were dysphagia and regurgitation in pharyngoesophageal diverticula. Dysphagia, substernal pain and hiccough in parabronchial and epiphrenic diverticula. The treatment was resection of diverticula which was combined with myotomy in case of pharyngoesophageal diverticula. 2 patients had severe secondary wound healing. Other postoperative dysfunctions of the esophagus or symptomatic recurrences were not seen.
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PMID:[Esophageal diverticula. Clinical aspects and therapy]. 190 78

Paraesophageal hiatal hernia accounts for only five per cent of all diaphragmatic defects but is a potentially dangerous lesion. Herniation of the entire stomach, at times accompanied by the omentum, transverse colon, and small bowel, may occur in some patients, and incarceration and strangulation may be the result. Three patients underwent repair of large paraesophageal hernias, in one instance as an emergency. Symptoms of pain, bloating, and occasional regurgitation had been present for 17, 30, and 40 years. The operations included repair of the hiatal defect, anterior gastropexy, and Nissen fundoplication in two patients. In the third patient, a pyloromyotomy was performed as well. A subsequent thoracotomy was necessary in one patient to excise a persistent large hernia sac, which was densely adherent to the lung and mediastinal structures. All patients were asymptomatic after periods of 9 months, 1 year, and 7 years. The unique anatomic and clinical features of large paraesophageal hernias containing intrathoracic abdominal viscera, as well as the technique of operative repair, are presented.
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PMID:Repair of large paraesophageal hernia with complete intrathoracic stomach. 192 81

The efficacy of the prostaglandin analogue, rioprostil, in the treatment of reflux oesophagitis has been assessed in a double-blind, randomized, placebo-controlled trial of 25 patients with endoscopic and histological evidence of reflux oesophagitis. At the beginning and end of the study, endoscopic appearances were graded 0-4 (0 = no oesophagitis, 4 = severe oesophagitis) and the symptoms of heartburn, regurgitation, pain and dysphagia were each graded 0-3 (0 = none, 3 = severe). Fourteen patients received rioprostil, 300 micrograms twice daily, and 11 patients received identically marked placebo for a period of 12 weeks. At the end of the study there were no significant differences between the groups in mean (s.d.) endoscopic grading (rioprostil 2.4 (1.3); placebo 1.9 (0.9)) and mean (s.d.) cumulative symptom score (rioprostil 2.5 (3.1); placebo 2.6 (1.5)). Five patients in the rioprostil group reported diarrhoea. Rioprostil had no significant benefit over placebo in the treatment of reflux oesophagitis.
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PMID:Prostaglandins in the treatment of reflux oesophagitis: double-blind placebo controlled clinical trial. 194 33

A conservative surgical technique is proposed as an alternative to the classical uvulopalatopharyngoplasty (UPPP) for the treatment of obstructive sleep apnea and snoring. The resection is strictly intrapalatine, and careful suturing in three planes seems to lead to complete disappearance of the often unbearable postoperative pain. The soft palate is shortened but nonetheless still resembles a normal soft palate. Uvulopalatopharyngoplasty (UPPP) was described by Ikematsu in 1952. This method has taken on a new lease of life in recent years. Its efficacy is generally accepted, and its use, especially in cases of obstructive sleep apnea syndrome, is the only treatment of the palatal velum at present practiced. In addition to aesthetic problems, this method generally gives rise to complications in the shape of temporary--but sometimes considerable--pain, nasal regurgitation, and a nasal voice. In a small percentage of patients, some of these disorders may prove irreversible. In my series of eight patients, five were obese and presented with hypertension. Three of them also were suffering from obstructive sleep apnea syndrome. The three others were ordinary snorers who caused considerable inconvenience to sleeping partners.
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PMID:Intrapalatine resection (IPR) in the treatment of sleep apnea and snoring. 199 17

Chronic intermittent duodenal obstruction caused by stenosis of the distal duodenum is a rare disease. Tight fixation of the ligament of Treitz, compression due to mesenteric lymphomatas or abnormal attachment of the mesocolon can cause intermittent impairment of intestinal passage. It will be necessary to differentiate this against genuine arterio-mesenteric duodenal obstruction as well as nerve motility disorders. History in the appropriate cases reports on postprandial episodes of regurgitation, sensation of fullness, nausea, vomiting and paroxysmal upper abdominal colicky pain. Radiograms always reveal gastroptosis and a varying degree of duodenal obstruction, usually with retroperistalsis. The passage is markedly delayed, with an impairment sometimes at the site of the duodenojejunal flexure. Therapy is always surgical. 8 own cases were cured by leftsided duodenal mobilisation according to Clairmont with additional caudad positioning and fixation of the duodenojejunal flexure.
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PMID:[Chronic intermittent duodenal obstruction in childhood]. 229 39

This review describes our use of the Dor operation in the management of 22 patients with achalasia of the cardia over the period 1970 to 1989. There was a male to female ratio of 1.8:1. All presented with dysphagia of varying degree, with regurgitation (86%), weight loss (73%), pain (59%) and chest infections (14%) being associated symptoms. Two patients had undergone previous balloon dilatation, with temporary benefit. The morbidity was low and follow-up results were good in 94% of cases. None of the patients had symptoms of gastro-oesophageal reflux in the postoperative period. In our experience, the Dor modification of the Heller operation has yielded gratifying results.
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PMID:Surgery for achalasia cardiae: the Dor operation. 233 94

After a review of the literature a study was conducted into oesophageal cancers among elderly patients in Pavia University's Institute of Surgical Pathology in 1974-1985. The results led to the following conclusions: this disease occurs most often among the elderly especially those in their sixties; symptoms (dysphagia, weight loss, regurgitation with epigastric and retrosternal pain are initially unclear which makes early diagnosis difficult; most cases require surgery. It is concluded that the appropriate tests should be performed at the first warning signs and that, once the condition is diagnosed, the elderly patient should be prepared for surgery which should be as radical as possible.
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PMID:[Cancer of the esophagus in the elderly]. 262 48


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