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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Liquid paraffin pneumonia was diagnosed after open lung biopsy in a woman age 73 with a hiatus hernia and rheumatoid arthritis who had been taking liquid paraffin nightly for fifty two years. Histological examination showed a lipid type pneumonia with involvement of alveoli, interstitial tissues and brochioles. Chemical analysis of the lung showed total lipids of 17.7% (w/w), 86% was liquid paraffin which was positively identified by infrared spectroscopy. Transmission electronmicroscopy showed macrophages in the alveoli filled by phagosomes. The alveoli were mainly lined by alveolar type II cells. Scanning electronmicroscopy showed alveoli filled by a mass of vacuoled material.
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PMID:Liquid paraffin pneumonia--with chemical analysis and electronmicroscopy. 16 Jun 64

The differential diagnosis of a left lower lobe cavity in this young patient with a history of productive cough should include hiatal hernia, pulmonary abscess, bronchiectatic cyst and bronchopulmonary sequestration. Hiatal hernia should be ruled out by barium swallow; acute pulmonary abscess by the lack of a history suggestive of a necrotizing pneumonia; bronchiectasis by bronchogram; and intralobar bronchopulmonary sequestration should be confirmed by aortography.
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PMID:Radiologic differential diagnosis. Radiologic pattern: solitary cavity. 102 65

A-79-year old man, treated by thoracic fundoplication for hiatus hernia with symptomatic gastroesophageal reflux, 12 years previously, was examined for persistent cough and left basal pneumonia. Esophagogastroscopy revealed a gastrobronchial fistule which was confirmed by endoscopical fistulograms. Surgical treatment led to complete recovery of the patient. A review of the literature confirms the rarety of this ailment as well as the relevance of preoperative diagnosis by perendoscopical fistulograms.
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PMID:[Gastrobronchial fistula]. 147 10

Twelve patients presenting with symptomatic esophagitis associated with hiatal hernia and gastroesophageal reflux underwent operative management under laparoscopic guidance. The antireflux procedure employed was the Nissen fundoplication. The authors completed the operation laparoscopically in nine patients. Postoperatively, patients were evaluated with repeat fiberoptic endoscopy, esophageal manometry, and barium contrast studies. Postoperative results were considered excellent on the basis of these studies and complete control of symptoms. The mortality rate was 0%. The only major operative complication was a pneumonia that occurred in one patient. At 1 month follow-up, six patients were totally asymptomatic. The authors conclude that laparoscopic treatment of gastroesophageal reflux associated with a hiatal hernia is feasible by a procedure that has already proven its value during open surgery.
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PMID:Laparoscopic Nissen fundoplication: preliminary report. 166 93

Unique problems accompany percutaneous endoscopic gastrostomy (PEG) in head and neck cancer patients. This study analyzed the experience of one surgeon (P.S.) performing PEG in 50 patients with advanced oropharyngeal cancer. The records of 54 such patients consecutively referred for PEG at the Massachusetts General Hospital were reviewed. A pull-through PEG technique was used. The procedure was successful in 50 patients (success rate, 93%). Failures were caused by esophageal stricture, respiratory distress, and hiatus hernia. The two patients with insurmountable esophageal stricture had piriform sinus tumors. Cancer in this location and pharyngoesophageal strictures were predictive of PEG failure. A single death, 21 days after endoscopy, was caused by pneumonia. The only major complications were two transient respiratory arrests. Neither patient had a tracheostomy in place, and both had unresected cancer present. Minor complications were transient gastroparesis, pneumonia, unexplained fever, and a broken traction suture. There were no wound or intraabdominal infections and no episodes of bleeding. While PEG was successful in 93% of these difficult patients, with few complications, results could be improved by tracheostomy or resection performed before PEG in patients with tumors near the airway and dilatation of troublesome esophageal strictures under endoscopic view before PEG.
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PMID:Percutaneous endoscopic gastrostomy in head and neck cancer patients. 250 Aug 99

Clinical signs of esophageal hiatal hernia in four dogs and one cat included regurgitation, vomiting, hematemesis, hypersalivation, dysphagia, and dyspnea. Thoracic radiographs, esophagram, and fluoroscopy were used to demonstrate cranial displacement of the esophagogastric junction and part of the stomach through the esophageal hiatus. Other findings included megaesophagus, esophageal hypomotility, gastroesophageal reflux, and pneumonia. Medical therapy failed to resolve the clinical signs. Reduction in size of the esophageal hiatus, fixation of the esophagus to the diaphragmatic crus (esophagopexy), and a left fundic gastropexy were performed. Surgical results were considered good to excellent.
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PMID:Hiatal hernia repair by restoration and stabilization of normal anatomy. An evaluation in four dogs and one cat. 281 56

Fifty-seven of 101 Nissen fundoplications during the 4-year period, July 1979 to July 1983, were performed on neurologically impaired children. Mean age at the time of surgery was 5.9 years (range 1 month to 22 years). Indications for operation included: persistent vomiting, 57 patients (100%); failure to thrive, 49 patients (86%); repeated episodes of pneumonia, 49 patients (86%); esophagitis, 18 patients (32%); hiatal hernia, 14 patients (25%); episodes of apnea, 10 patients (18%); and esophageal stricture, six patients (10%). Forty-six of the 57 patients had previously failed a standard trial of nonsurgical management. Gastroesophageal reflux was documented by barium esophagograms in 51/56 patients (91%), chalasia scans in 28/32 patients (88%), esophagitis or stricture at endoscopy in 21/23 patients (91%), and acid reflux on pH monitoring in 13/16 patients (80%). Operative management included gastrostomy in 55 of the 57 patients and this was permanent in 50. Gastrostomies had previously been performed in nine patients but had failed to provide a reliable method of enteral feeding because of chronic reflux and aspiration. The surgical complication rate was 12%. Intraoperative esophageal perforation occurred in two patients, splenic tear in one, hepatic vein laceration in one, and a tight wrap in one. After surgery, bowel obstruction from adhesions developed in one patient and a midgut volvulus in another. Five of the children have died, none from causes related to the surgical procedure. Clinical and radiologic follow-up evaluations of all survivors have been done, with a mean follow-up of 3 years. In four patients the repair was felt to be inadequate. One patient had an esophageal stricture and three had recurring episodes of pneumonia. Three children showed radiologic evidence of persistent reflux, but only two were symptomatic. Two patients required a second antireflux procedure for reflux and are now free of symptoms. Nissen fundoplication appears to be a safe and beneficial procedure in neurological impaired children. Long-term follow-up evaluation of these patients showed satisfactory growth as well as a significant decrease in pulmonary disease associated with aspiration.
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PMID:The effectiveness of Nissen fundoplication in neurologically impaired children with gastroesophageal reflux. 2325 71

Gastro-oesophageal reflux was demonstrated in 5 cases of bronchiolitis obliterans with apparently cryptogenetic organizing pneumonia. In addition, one patient had hiatus hernia and another, oesophageal diverticulum. In 4 patients, after failure of prolonged antibiotic therapy, medical or surgical treatment of the gastro-oesophageal reflux resulted in regression of the clinical and radiological signs of pulmonary lesions. The cure thus obtained persisted throughout a follow-up period of 2 months to 8 years. Gastro-oesophageal reflux therefore could be one of the causes of apparently cryptogenetic bronchiolitis obliterans with organizing pneumonia, and all patients with this respiratory disease should be investigated for gastro-oesophageal reflux.
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PMID:[Bronchiolitis obliterans with cryptogenetic-like organizing pneumonia. Demonstration of gastro-esophageal reflux in 5 cases]. 297 80

Two cases of sudden death due to perforation of a benign oesophageal ulcer into a major blood vessel are reported. In one man, anaemia and aspiration pneumonitis dominated the clinical picture. He had an oesophageal stricture and a chronic peptic ulcer associated with an incarcerated hiatus hernia. Death was due to haemorrhage caused by perforation of the ulcer into the thoracic aorta. The second patient presented with confusion and falls, backache and indigestion. She had a hiatus hernia and a large benign chronic oesophageal ulcer. Death was due to perforation of the ulcer into the left pulmonary vein. The cases are presented for their rarity, to illustrate the complex and late presentation of problems in geriatric medicine, and as a reminder that reflux oesophagitis can be dangerous.
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PMID:Sudden death from perforation of a benign oesophageal ulcer into a major blood vessel. 325 Dec 22

Thirty five severely mentally retarded children with significant gastro-esophageal reflux were submitted to surgical treatment. The age range was 2 months to 13 years. Characteristics and presenting symptoms were chronic vomiting (62%), merycism (43%), gastro-intestinal blood loss (37%), recurrent pneumonia (65%) and failure to thrive (57%). Barium esophagogram demonstrated free gastro-esophageal reflux in all patients with an associated hiatus hernia being noted in 3 cases. An upper gastro-intestinal endoscopy was performed in 24 children. Esophagitis of 2 or 3 degrees was present in 16 cases. A standard medical treatment was used in all patients during 1 month to 3 years. The patients were referred for surgery because they had no response to medical management or they had hiatus hernia or esophagitis type II or III. The operative procedure performed was Nissen fundoplication without gastrostomy. The mean duration of follow-up was 5 years (range 6 months to 12 years). We have not reviewed 5 patients. Several post-operative complications occurred: 4 pneumonia (2 deaths), 2 small bowel obstructions, 4 dumping syndrome and 1 death without etiology. Late complications were important too: 6 persistent reflux, 2 small bowel obstructions (2 deaths) and 2 peritonitis (2 deaths). Three patients died of their brain damage during the study period, 6 months to 8 years following their surgical procedure. The authors insist on: The frequency of gastro-esophageal reflux in retardates with a frequent merycism associated. The search for this reflux must be systematically done because it provokes some respiratory problems and a bad general status which distressed the child but also the family or the institution caring for the child.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Nissen's operation in children with brain diseases]. 376 12


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