Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report three successful cases of treating intractable abdominal fullness associated with cancer by continuous thoracic epidural analgesia. Case 1 was a 31-year-old woman with sarcoma of the uterus suffering from back and epigastric pain; abdominal fullness was treated by continuous epidural analgesia with ropivacaine and morphine. After epidural analgesia, symptoms disappeared and removal of ascites was unnecessary. Case 2 was an 18-year-old woman with Ewing's sarcoma suffering from abdominal fullness and fentanyl patch-resistant cancer pain. After continuous epidural analgesia, symptoms disappeared and she was discharged for home care. Case 3 was a 63-year-old woman with advanced liver cancer who was treated with epidural analgesia for cancer pain. She also suffered from abdominal fullness due to meteorism caused by intestinal hypomotility by cancer invasion to the spine. Thoracic epidural analgesia effectively treated cancer pain and reduced abdominal fullness, allowing her to continue hospital visits. Our findings suggest that epidural analgesia may effectively treat opioid-resistant intractable abdominal fullness.
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PMID:[Three successful cases of relieved abdominal fullness by thoracic epidural analgesia]. 2449 83

Polycystic kidney disease (PCKD) is rarely associated with aortic dissection (AD), which is a life-threatening disease. Although endovascular stent-graft repair tends to show better outcomes than conventional therapies in complicated type B AD (TBAD), successful endovascular intervention of TBAD with malperfusion in a patient with PCKD has not been reported. This case shows a 37-year-old male who had sudden onset of sharply stabbing epigastric pain with severe hypertension, who was diagnosed with TBAD and PCKD by a computed tomography and initially underwent medical treatment. Four days after discharge, he was rehospitalized with left leg pain and paresthesia due to left lower leg malperfusion. Thoracic endovascular stent-graft repair covering the primary tear site of dissection was performed successfully, leading to a decrease in false lumen and improvement of symptoms. We report the case of complicated TBAD in a patient with PCKD treated with endovascular stent-graft repair.
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PMID:Successful Endovascular Stent-Graft Repair for Complicated Type B Aortic Dissection Developed in a Patient with Polycystic Kidney Disease. 2621 46

BACKGROUND Hemetemesis is rarely caused by an aorta-esophageal fistula with thoracic aorta aneurysm in patients. This uncommon etiology, AEF/TAA, can potentially rupture and cause death if left untreated. Thoracic endovascular aorta repair places a stent-graft to seal the aneurysm and cover the fistulous track. Open surgical repair is associated with high risk of morbidity and mortality; therefore, TEVAR is a much safer alternative to it. However, recurrent or persistent infection remains a major concern with TEVAR for AEF. CASE REPORT We present a rare case of an 80-year-old woman who presented with complaints of hemetemesis and epigastric pain. The patient underwent a computerized tomography scan, highlighting a TAA and AEF. A stent was placed in the descending thoracic aorta via endovascular approach and a subsequent EGD was negative for any residual bleeding. Methicillin-resistant Staphylococcus aureus was isolated from the patient's sputum cultures and she was treated with a prolonged course of antibiotics. She presented to the hospital a few weeks later with new-onset hematemesis. Workup identified an AEF. The patient was high risk for open surgical repair due to her comorbid conditions; therefore, an esophageal stent was placed. She was diagnosed with AEF secondary to an infected endovascular thoracic aorta stent. CONCLUSIONS Patients who are high risk for open surgical repair from immediate rupture of TAA with AEF can benefit from use of the TEVAR approach. The stent itself is a foreign body; therefore, the risk of infection persists. AEF is a rare but potentially fatal complication of the infected thoracic aortic stent itself.
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PMID:Aortoesophageal Fistula: A Fatal Complication of Thoracic Endovascular Aortic Stent-Graft Placement. 3034 37