ABSTRACT
This study included twenty patients with different non corrosive oesophageal causes of dysphagia that dilated without complications. Followed up for about one year. Improvement occurred in sixteen patients [80 %] whereas failure in-four patients [20%]. Dilatation was done under general anesthesia with endoscopic and fluoroscopic guidance.- Balloon dilatation of esophageal strictures is a safe, effective, low cost technique.- Balloon catheter dilatation is more effective and with less traumatic effect than the traditional dilators.- It is a good and effective technique in those patients who had failure of dilatation with traditional methods due to difficult strictures [long segment, tortous, tight]. Thus, surgery was avoided with its morbidity, mortality and cost.- It is an effective treatment for achalasia with good results and no complications. It also performed in patients less than 12 years old. Using fluoroscopy with guide wire increases its safety as it allows for complete visualization as the balloon is positioned and inflated, thereby decreasing the risk of perforation- Endoscopy plays an important role in direct assessment of the stricture and evaluation the results after dilatatio
ABSTRACT
Superselective preoperative percutaneous transfemoral catheter embolization by using polyvinyl alcohol particles of feeding vessels in glomus jugulare tumors, followed two-three days by application of standard surgical techniques, presents the treatment of choice, allowing meticulous microsurgery with virtually complete haemostasis. Therefore, the surgeon can operate in a bloodless environment throughout the compressed anatomic field, amidst such important yet vulnerable structures as cranial nerves, inner ear, carotid artery, jugulare bulb, venous sinuses and dura, while reducing surgical error and functional deficit for the patient. The value of this combined approach was analyzed for the management of ten patients suffered from glomus tumors at Assiut University Hospital. The results showed that even extensive tumors of the middle ear, jugulare bulb and mastoid had only minor blood losses and good surgical outcome with this treatment modality. Combined embolization and surgery offer the best approach for the treatment of respectable glomus jugulare tumors
Subject(s)
Humans , Male , Female , Neoplasm Staging , Embolization, Therapeutic , Postoperative Complications , Tomography Scanners, X-Ray ComputedABSTRACT
The aim of this study was to assess the short-term effects of a single 5-L paracentesis without albumin replacement on the systemic and portal hemodynamics. Thirty patients with liver cirrhosis and tense, diuretic resistant ascites were studied before and 24 hr after a single 5-L paracentesis without albumin infusion. An abdominal duplex Doppler examination and echocardiographic study were carried out for all patients. Heart rate and blood pressure were measured. The mean arterial pressure was calculated. Serum sodium, potassium, blood urea and creatinine were also measured. There were no significant changes from the baseline values for heart rate, mean arterial pressure and cardiac output. As regards portal hemodynamics, there were no significant changes in portal vein diameter, portal flow velocity and portal blood flow before and 24 hr after large volume paracentesis. The study concluded that single large volume paracentesis without albumin replacement is safe and satisfactory short-term option for the management of patients with cirrhosis and tense, diuretic resistant ascites