ABSTRACT
Symptomatic muscular rings are extremely rare, and some authors have even disputed their existence. The lower esophageal muscular ring, or A ring, located about 2cm proximal to the squamocolumnar junction and are covered by squamous epithelium. These rings consist of an annular narrowing of hypertrophic muscular tissue in the esophageal body. Recently, we experienced 2 cases of symptomatic muscular ring of the esophagus and the findings. Case 1) A 52 year-old male with dysphagia, chest pain and regurgitation for several years, had esophagogram, endoscopy, esophageal motility studies and chest CT. Under the diagnosis of esophageal muscular ring, the patient had pneumatic baUoon dilatation (3.0 cm in diameter, Rigiflex), under which the patient experienced perforation of the lower esophagus and required surgery. We confirmed muscular ring of the esophagus as shown by a thickened muscularis propria layer, without other pathologic findings. Case 2) A 60 year-old male complaining of intermittent dysphagia, had esophagogram, endoscopy, esophageal motility studies and EUS. Under the diagnosis of esophageal muscular ring, he is now being treated with calcium channel blocker and nitrate, and has experienced minimal symptom improvement. We report 2 cases of symptomatic muscular ring of low esophagus with review of literature.
Subject(s)
Humans , Male , Middle Aged , Calcium Channels , Chest Pain , Deglutition Disorders , Diagnosis , Dilatation , Endoscopy , Epithelium , Esophagus , Tomography, X-Ray ComputedABSTRACT
Pseudoachalasia is a distinct clinical entity that mimics idiopathic achalasia. However, the pathophysiology of pseudoachalasia is debated. Although neoplastic involvement of the distal esophagus is the most common cause of pseudoachalasia, benign disease of the distal esophagus could result in clinical entity of pseudoachalasia as well. We report a case of pseudoachalasia following a benign esophageal stricture by gastroesophageal reflux disease, which needs to differentiate from malignant esophageal strictures.
Subject(s)
Constriction, Pathologic , Esophageal Achalasia , Esophageal Stenosis , Esophagus , Gastroesophageal RefluxABSTRACT
Cystic dilatation of the biliary tree, so called choledochal cyst, is an uncommon disease and is not uncommonly associated with carcinoma. The most symptoms on. presentation are abdominal pain, weight loss, jaundice, and palpable mass. The prognosis of these lesions is dismal. Recently we experienced a case of carcinoma arising in a choledochal cyst in 27-year-old male complaining jaundice and fever. ERCP revealed marked dilated the CBD and obstruction of the proximal portion of the CHD. A computerized tomographic scan and percutaneous cholangiogram showed cystic dilatation of both intrahepatic ducts and solid mass in the left hepatic duct. The patient was treated with surgical resection. Pathologic studies disclosed an adenosquamous carcinoma.
Subject(s)
Adult , Humans , Male , Abdominal Pain , Biliary Tract , Carcinoma, Adenosquamous , Cholangiopancreatography, Endoscopic Retrograde , Choledochal Cyst , Dilatation , Fever , Hepatic Duct, Common , Jaundice , Prognosis , Weight LossABSTRACT
Esophageal duplication cysts account for a very small percentage of benign esophageal tumors and are infrequently symptomatic. Esophageal duplication cysts result from aberrant alignment of the normal vacuolization process that produce the esophageal lumen in the 5th to 8th week of embryonic life. Complications most often are bleeding into or infection of cysts. Recently, we experienced a case of esophageal duplication cyst complicated with intramural huge hematoma and the cause of hematoma could not be identified. We report it with a review of literatures.
Subject(s)
Humans , Male , Middle Aged , Esophageal Cyst/complications , Follow-Up Studies , Hematoma/complications , Mediastinal Diseases/complicationsABSTRACT
Xanthogranulomatous cholecystitis is an uncommon inflammatory disease of the gall baldder characterised by a focal or diffuse destructive inflammatory process. The pathogenesis is uncertain, but an inflammatory response to extravasated bile due to acute inflammation and obstruction is likely. Macroscopically, the gall bladder wall is invariably thickened, and extensive adhesions to adjacent organs are frequent. Clinically, xanthogranulomatous cholecystitis can mimic gall bladder carcinoma and radiologic differential diagnosis is extremely difficult. Fistula to skin and duodenum was reported. We report the first case of cholecysto-colonic fistula due to xanthogranulomatous cholecystitis.