ABSTRACT
Percutaneous balloon angioplasty was used to dilate inferior vena cava (IVC) stenosis in 12 patients with Budd Chiari syndrome. There were seven men and five women, aged 32.8 +/- 8.5 years. Angioplasty was performed using balloon 18-20 mm in diameter. In eleven (91.6%) patients, IVC could be successfully dilated. In these eleven patients, the caval diameter at the site of stenosis increased from 2.3 +/- 1.5 to 13.1 +/- 2.8 mm (p < 0.001), the mean IVC pressure decreased from 28.2 +/- 4.1 to 10.5 +/- 3.4 mmHg (p < 0.001) and the gradient across the stenosis decreased from 23.1 +/- 2.2 to 4.2 +/- 1.9 mmHg (p < 0.001). There was appreciable clinical improvement after angioplasty. On a mean followup of 10.8 (3-18) months four (36.4%) patients had restenosis which could be successfully dilated again. These results suggest that balloon dilatation of inferior vena cava stenosis is safe and effective, however, recurrence is common and needs redilatation.
Subject(s)
Adolescent , Adult , Angioplasty, Balloon, Coronary/methods , Budd-Chiari Syndrome/complications , Constriction, Pathologic/etiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Portography , Recurrence , Retrospective Studies , Treatment Outcome , Vena Cava, Inferior/pathologyABSTRACT
Corrosive injury to the UGI tract is a common problem and has a wide spectrum of presentations. Unlike in the West, where lye ingestion is more frequent, corrosive injury in India is more commonly due to acids. Depth of the injury is the most important factor which determines the outcome. Endoscopy done soon after corrosive ingestion is safe and is very helpful in assessing the extent and severity of injury and in planning proper management of these patients. At present no therapy has been proven to be effective for prevention of stricture formation. Endoscopic dilatation seems to be the treatment of choice for management of most esophageal strictures with very good short and long term results. Surgery should be considered only when dilatation fails.
Subject(s)
Burns, Chemical/etiology , Caustics/adverse effects , Child , Digestive System/injuries , Esophageal Stenosis/chemically induced , Humans , Stomach/injuriesSubject(s)
Adult , Colitis, Ulcerative/drug therapy , Female , Humans , Male , Aminosalicylic Acid/therapeutic useABSTRACT
Histopathological changes in the esophagus and gastric antrum were studied in 47 patients with duodenal ulcer. Twenty three (49%) patients complained of heartburn. Esophagitis was present in 87% of the patients with heartburn and in 71% of the patients with no heartburn. In the majority, esophagitis was of mild to moderate severity. Gastritis was present in 83% (atrophic type in 22%) of patients with heartburn compared to 96% (25% atrophic type) of patients without heartburn. There was no statistical difference in the incidence of esophagitis and gastritis between the heartburn and no heartburn groups. This study suggests that histologic esophagitis and gastritis occur frequently in patients with duodenal ulcer and the presence of heartburn is not related to these histologic changes.