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Esophagogastroduodenoscopy and endoscopic retrograde cholangiopancreatography
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Colin G. DeLong, Afif N. Kulaylat, Eric M. Pauli, Robert E. Cilley
Removal of an irregular object, such as impacted food material, may be facilitated by the passage of a balloon catheter beyond the material or with the use of a specialized retrieval device (e.g. nets, basket), which is then withdrawn under direct vision while the airway is controlled by endotracheal intubation. Other techniques include the use of suction catheters to pull a soft food bolus back or a “push” technique where the object is gently pushed into the stomach. Food impactions in previously healthy children without known esophageal disease should prompt consideration of eosinophilic esophagitis.
Muscle Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Kourosh Rezania, Peter Pytel, Betty Soliven
Esophageal disease, manifested by dysphagia, occurs in about 15–50% of patients. There are two main forms: Proximal dysphagia is caused by involvement of striated muscle of the pharynx or proximal esophagus, correlates with severity of the muscle disease, and responds to steroid treatment.Distal dysphagia is due to involvement of nonstriated muscle and is more common in patients who have an overlap with scleroderma or another collagen–vascular disorder.
Rational Medical Therapy of Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Richard M. Sperling, Kenneth R. McQuaid
Patients referred for evaluation of CPUE should undergo a careful history and physical examination. Particular inquiry should be made into symptoms of esophageal diseases such as heartburn, regurgitation, dysphagia, and odynophagia. It should be remembered that symptoms of gastroesophageal reflux are common and do not necessarily confirm a causative relationship. Patients should be asked about the possible relationship between chest pain and eating, drinking hot or cold liquids and carbonated beverages, posture, physical activity, and psychosocial stress. In addition, the physician should look for symptoms of other functional disorders such as chronic dyspepsia or abdominal pain, or IBS. Finally, the physician should evaluate the patient for psychosocial factors that may be causing or exacerbating the patient’s pain. Referral for formal psychological evaluation should be made as deemed appropriate.
Current status and advances in esophageal drug delivery technology: influence of physiological, pathophysiological and pharmaceutical factors
Published in Drug Delivery, 2023
Ai Wei Lim, Nicholas J. Talley, Marjorie M. Walker, Gert Storm, Susan Hua
Although topical drug delivery has obvious advantages for the treatment of esophageal diseases, there are currently very few marketed products available that are specifically indicated for the localized treatment of esophageal diseases. Local delivery of drugs across the esophageal mucosa is difficult due to the biological barriers that makes this organ relatively impermeable to compounds. Nevertheless, there is an urgent need for improved treatments for esophageal diseases that are both effective and safe. Further development and optimization of esophageal drug formulations have led to improvements in drug availability and formulation retention. However, despite the pharmaceutical advances in esophageal drug delivery to date, very few of them have translated to the clinical phase. This review will address the physiological, pathophysiological, and pharmaceutical considerations influencing esophageal drug delivery and formulation approaches. The translational challenges and development aspects of novel formulations will also be discussed.
S-POEM in treatment of achalasia and esophageal epiphrenic diverticula – single center experience
Published in Scandinavian Journal of Gastroenterology, 2020
Michal Demeter, Martin Ďuriček, Martin Vorčák, Rudolf Hyrdel, Rastislav Kunda, Peter Bánovčin
Symptomatic outcome. Mean Eckardt score at the time of POEM procedure was 6.6 (range 5–9), with the most common complaint of regurgitation (partial Eckardt score of 2), followed by dysphagia (1.8) and non-cardiac chest pain (1). In the 3 months follow up, we observed a significant decrease of Eckardt score (6.6 vs. 0.6, p < .0001). The average weight gain was 6.1 kg (range 0–15 kg). The median follow up time during telephone inquiry was 24 months (range 6–51 months), Eckardt score remained unchanged in six patients. One patient died 2 years after the procedure (aged 79 years) due to causes unrelated to the esophageal disease, his relatives reported him to be completely asymptomatic at the time of his death. A comprehensive review on the symptoms and outcome of each patient is provided in Table 1.
Cholecystectomy during esophagectomy is safe but unnecessary
Published in Acta Chirurgica Belgica, 2020
Francesco Cavallin, Marco Scarpa, Matteo Cagol, Rita Alfieri, Alberto Ruol, Vanna Chiarion Sileni, Massimo Rugge, Ermanno Ancona, Carlo Castoro
This is a retrospective cohort study aiming at evaluating the safety and the need of cholecystectomy during esophagectomy for cancer. All esophagectomies performed at Center for Esophageal Diseases located in Padova between 1 January 1992 and 31 December 2011 were retrospectively evaluated. The safety of cholecystectomy was evaluated by comparing surgical outcomes (length of stay, postoperative mortality and perioperative complications) in patients who underwent esophagectomy with concurrent cholecystectomy and in those who underwent standard esophagectomy. The occurrence of specific complications (hemorrhage in the abdomen, acute pancreatitis and bowel obstruction) were also retrieved. The need for cholecystectomy was evaluated in patients who underwent standard esophagectomy by assessing the occurrence of biliary duct stones and of cholelithiasis/cholecystitis during follow-up. Risk factors for receiving cholecystectomy during esophagectomy and those for the occurrence of cholelithiasis/cholecystitis after standard esophagectomy were also investigated. The study was conducted according to the Helsinki Declaration principles of 1975, as revised in 1983, and patients gave their consent to have their data collected for the scientific purpose. This retrospective cohort study was notified to the Ethical Committee of Veneto Oncology Institute (IOV-IRCCS) that did not find any ethical problems.