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1.
Article in Chinese | WPRIM | ID: wpr-920829

ABSTRACT

@#Surgery is a classic traditional method for the treatment of early-stage esophageal cancer, and it is also recognized as an effective first-choice method in the medical community. With the development of endoscopic technology, esophagus-preserving comprehensive treatment of esophageal cancer has almost the same or even better effects in some aspects in the treatment of early esophageal cancer than surgery. Many clinical guidelines have also recommended it as the first-choice treatment for early esophageal cancer. The room for surgical treatment of esophageal cancer has been further compressed. This article discusses the comprehensive treatment model of esophageal cancer from the perspective of thoracic surgery, aiming to find a new position of thoracic surgery in the treatment of esophageal cancer.

2.
Rev. colomb. cir ; 37(2): 312-317, 20220316. fig
Article in Spanish | LILACS | ID: biblio-1362981

ABSTRACT

Introducción. El divertículo de Zenker es una evaginación sacular ciega que puede presentarse a nivel faringoesofágico. No se conoce exactamente su incidencia en la edad pediátrica, constituyendo una patología muy infrecuente. La sintomatología es inespecífica, lo que dificulta el diagnóstico precoz y determina un mayor riesgo de complicaciones asociadas. Caso clínico. Paciente preescolar femenina con cuadro recurrente de emesis con deshidratación, posteriormente asociado a disfagia, a quien se le diagnosticó un divertículo de Zenker. Se realizó tratamiento quirúrgico con hallazgo intraoperatorio de dilatación esofágica, un área de estenosis secundaria al hallazgo incidental de un cuerpo extraño y divertículo de Zenker en la región lateral del esófago dilatado. Discusión. Esta patología es extremadamente rara, pero se debe tener en cuenta dentro de los diagnósticos diferenciales en pacientes con sintomatología faringo-esofágica. Conclusión. Se presenta una preescolar sin antecedente de procedimientos esofágicos o malformaciones congénitas asociadas con diagnóstico de un divertículo de Zenker y dilatación esofágica por un cuerpo extraño, tratada quirúrgicamente de forma exitosa.


Introduction. Zenker's diverticulum is a blind saccular evagination that can present at the pharyngoesophageal level. Its incidence in pediatric age is not exactly known, constituting a very infrequent pathology. The symptoms are nonspecific, which makes early diagnosis difficult and determines a higher risk of associated complications.Clinical case. Female preschool patient with recurrent dehydration due to emesis, later associated with dysphagia, who was diagnosed with Zenker's diverticulum. Surgical treatment was performed with intraoperative finding of esophageal dilation, an area of stenosis secondary to the incidental finding of a foreign body, and a Zenker's diverticulum in the lateral region of the dilated esophagus. Discussion. This pathology is extremely rare, but it should be taken into account within the differential diagnoses in patients with pharyngo-esophageal symptoms. Conclusion: We present a preschool female patient with no history of esophageal procedures or congenital malformations associated with a diagnosis of Zenker's diverticulum and esophageal dilation due to a foreign body, successfully treated surgically.


Subject(s)
Humans , Foreign-Body Reaction , Zenker Diverticulum , Esophageal Stenosis , Pharynx , Diverticulum , Esophagus
3.
Rev. cuba. med. mil ; 50(3): e1289, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1357294

ABSTRACT

Introducción: La manometría esofágica de alta resolución es la prueba ideal para el diagnóstico de la acalasia y muestra la presencia de ondas terciarias o aperistalsis y el aumento de presión, con ausencia de relajación, del esfínter esofágico inferior. Objetivo: Evaluar la utilidad de la manometría esofágica de alta resolución en el diagnóstico y clasificación de la acalasia esofágica. Métodos: Se realizó una investigación descriptiva, trasversal, en el Centro Nacional de Cirugía de Mínimo Acceso entre octubre del 2018 y diciembre del 2019, en 46 pacientes con diagnóstico de acalasia esofágica. Se excluyeron aquellos con cirugía previa del esófago. Las variables incluidas fueron: edad, sexo, tiempo de evolución, síntomas y hallazgos manométricos. Para el análisis de las variables cuantitativas se emplearon medidas de tendencia central, media y de dispersión, la desviación estándar. Las frecuencias y proporciones fueron utilizadas para describir las variables cualitativas. Resultados: Predominó la acalasia tipo II, en el sexo femenino (57 por ciento). La disfagia fue el síntoma más frecuente (84, 76 y 100 por ciento en los tipos I, II y III, respectivamente). El 70 por ciento de los casos presentó más de un año de evolución de los síntomas. La media de la presión de relajación integrada estuvo por encima de 21 mmHg independientemente del tipo. No se encontraron pacientes con subtipos de la acalasia tipo III. Conclusiones: La manometría esofágica de alta resolución es útil para el diagnóstico y clasificación de la acalasia esofágica(AU)


Introduction: High-resolution esophageal manometry is the ideal test for the diagnosis of achalasia and shows the presence of tertiary waves or aperistalsis and increased pressure, in the absence of relaxation, of the lower esophageal sphincter. Objective: To assess the usefulness of high-resolution esophageal manometry in the diagnosis and classification of esophageal achalasia. Methods: A descriptive, cross-sectional investigation was carried out at the National Center for Minimal Access Surgery, between October 2018 and December 2019, in 46 patients with a diagnosis of esophageal achalasia. Those with previous esophageal surgery were excluded. The variables included were: age, sex, time of evolution, symptoms and manometric findings. For the analysis of the results, the percentage and measures of central tendency (arithmetic mean and standard deviation) were used. Results: Type II achalasia predominated in females (57 percent). Dysphagia was the most frequent symptom (84, 76, and 100 percent in types I, II, and III, respectively). 70 percent of the cases presented more than one year of evolution of the symptoms. Regarding the high-resolution manometry parameters, it was observed that regardless of the type, the mean integrated relaxation pressure was above 21 mmHg. No patients with type III achalasia subtypes were found. Conclusions: High-resolution esophageal manometry is useful for the diagnosis and classification of esophageal acalasia(AU)


Subject(s)
Humans , Deglutition Disorders , Esophageal Achalasia/diagnostic imaging , Epidemiology, Descriptive , Cross-Sectional Studies , Manometry/methods
4.
Arq. gastroenterol ; 58(3): 296-301, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1345287

ABSTRACT

ABSTRACT BACKGROUND: High-resolution manometry (HRM) represents a potential tool for measuring pharyngoesophageal phonation pressures. OBJECTIVE: This study aims to evaluate pharyngeal, esophageal upper sphincteric and esophageal pressures during different phonation tasks. METHODS: 12 (six males, mean age 27 years) professional singers underwent HRM and produced four different vocal tasks at low, medium and high vocal loudness: vowel /ae/, ascending five note scale, word /hey/ and word /go/. Pressures were measured at pharynx, upper esophageal sphincter (UES) and esophagus. Visual analysis of the HRM topographic plots were performed. RESULTS: Esophageal pressures are higher during vocalization than at rest. Pharyngeal and UES phonation pressures does not differ significantly from rest pressures. Visual analysis of the topographic plots showed an important UES pressure increasement during phonation. CONCLUSION: HRM is a valuable tool for measuring pharyngoesophageal pressures during phonation. Esophageal pressures are higher during phonation than at rest and tend to increase with vocal loudness increment. The topographic plot provides additional data about phonatory mechanism physiology, especially at the UES region.


RESUMO CONTEXTO: A manometria de alta resolução (MAR) é uma ferramenta de grande potencial para mensuração das pressões faringoesofágicas durante a fonação. OBJETIVO: O estudo visa avaliar pressões faringianas, do esfíncter esofagiano superior e do esôfago durante manobras fonatórias. MÉTODOS: Doze (seis homens, idade média 27 anos) cantores profissionais foram submetidos à MAR e produziram quatro tarefas vocais em intensidade baixa, média e alta: vogal / ae /, escala ascendente de cinco notas, palavras /hey/ e /go/. Pressões aos níveis da faringe, esfíncter esofagiano superior e esôfago foram aferidas além de análise visual dos traçados. RESULTADOS: Pressões esofágicas foram maiores na vocalização que no repouso. Pressões da faringe e esfíncter esofagiano superior durante a fonação não foram diferentes que no repouso. Análise visual dos traçados mostrou importante incremento da pressão do esfíncter durante a fonação. CONCLUSÃO: MAR é uma ferramenta valiosa para mensurar as pressões faringoesofágicas durante a fonação. Pressões esofágicas são maiores durante a fonação que no repouso e tendem a aumentar com maior intensidade sonora. Análise visual dos traçados mostram dados adicionais sobre a fisiologia do mecanismo da fonação, especialmente na região do esfíncter esofagiano superior.


Subject(s)
Humans , Male , Adolescent , Pharynx , Esophageal Sphincter, Upper , Pressure , Deglutition , Manometry
5.
Arq. bras. med. vet. zootec. (Online) ; 73(4): 885-892, Jul.-Aug. 2021. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1285284

ABSTRACT

The Muscovy duck is a commercially important bird on the island of Marajó usually raised in a peculiar system that includes supplying fish viscera to the birds under semi-extensive farming conditions. This enables a risk of contamination and losses in the production of these birds, resulting from injuries caused by helminth infections, especially nematodes. The objective of this study was to evaluate the histopathological changes caused by nematodes of the genera: Eucoleus, Anisakis and Contracaecum. Thirty-three ducks with lesions in the esophagus and ventricle were analyzed. Histopathological exams showed a mild inflammatory infiltrate in the submucosa of the esophagus caused by the fixation of E. contortus and third stage larvae of Anisakis sp., and we recorded third stage larvae of Contracaecum sp. parasitizing the ventricle, this being the first record of this parasite in ducks in Brazil.(AU)


O pato doméstico é uma ave amplamente comercializada na Ilha de Marajó, com um peculiar manejo que inclui a oferta de vísceras de peixes aos animais em criações semiextensivas, propiciando, assim, risco de contaminação e perdas na produção dessas aves decorrentes de lesões oriundas de infecções por helmintos, especialmente os nematódeos. Nesse sentido, objetivou-se avaliar as alterações histopatológicas causadas por nematódeos dos gêneros: Eucoleus, Anisakis e Contracaecum. Foram analisados 33 patos, e três exemplares apresentaram lesões no esôfago e no ventrículo. Exames histopatológicos demonstraram discreto infiltrado inflamatório na submucosa do esôfago ocasionado pela fixação de E. contortus e larvas de terceiro estágio de Anisakis sp., bem como foram registradas larvas de terceiro estágio de Contracaecum sp. parasitando o ventrículo, sendo esse o primeiro registro desse parasito em patos no Brasil.(AU)


Subject(s)
Animals , Ducks/injuries , Ducks/parasitology , Esophagus/injuries , Helminths/isolation & purification , Nematoda/isolation & purification , Parasitic Diseases/complications , Brazil
6.
Medisur ; 19(3): 524-529, 2021. graf
Article in Spanish | LILACS | ID: biblio-1287334

ABSTRACT

RESUMEN: La ingestión intencional de cuerpos extraños es frecuente entre prisioneros. Es un fenómeno asociado a un aumento de la morbimortalidad y los costos. Generalmente no requiere de intervención específica, aunque pueden aparecer complicaciones severas, que requieren, en ocasiones, tratamiento quirúrgico urgente. Se presenta un paciente masculino, de 24 años de edad, sin antecedentes relevantes, recluido en la prisión de máxima seguridad de la provincia Camagüey. Se introdujo por la boca un alambre de 40 cm de longitud, con un gancho en su punta. Presentó sialorrea y molestias retroesternales. Al examen físico se encontró normalidad de sus parámetros vitales, sin alteraciones en el examen del tórax, con abdomen doloroso a la palpación profunda del cuadrante inferior derecho. Se realizaron radiografías simples de tórax posteroanterior, lateral, y de abdomen simple, se encontraron un cuerpo extraño desde la boca hasta el tercio inferior del esófago torácico y otro cuerpo extraño ubicado en la pelvis, que refirió haber ingerido intencionalmente hace un año. Se realizó laparotomía urgente y extracción de ambos cuerpos extraños. El paciente evolucionó satisfactoriamente sin desarrollar complicaciones. La ingestión intencional de cuerpos extraños en la población penal es un problema de salud complejo. La prevención es uno de los pilares fundamentales de su tratamiento. Es importante un alto índice de sospecha sobre la ingestión de múltiples objetos, en este grupo de pacientes la cirugía es frecuentemente requerida.


ABSTRACT The conscious ingestion of foreign bodies is frequent among prisoners. It is a phenomenon associated with an increase in morbidity - mortality and costs. Generally, it does not require specific intervention, although severe complications may appear, which sometimes require urgent surgical treatment.to present the case of a prisoner with recurrent intentional ingestion of multiple foreign bodies, one of them not previously diagnosed. Case presentation: A 24-years-old male patient, with no relevant history, held in the Camagüey province maximum security prison. The wire was introduced through the mouth 40 cm long, with a hook at its tip. Referring to hypersalivation and retrosternal discomfort. The physical examination found normality of his vital parameters, without alterations in the chest examination, with a painful abdomen on deep palpation of the right lower quadrant. A posteroanterior and lateral chest X-ray was performed, finding a foreign body from the mouth to the lower third of the thoracic esophagus, an abdominal X-ray where another foreign body was located in the pelvis, which he reported having intentionally ingested a year ago. An urgent laparotomy was performed and both foreign bodies were removed. The patient evolves satisfactorily without developing complications. The intentional ingestion of foreign bodies in the prison population is a complex health problem. Prevention is one of the fundamental pillars of its treatment. A high index of suspicion on the ingestion of multiple objects is important; in this group of patients surgery is frequently required.


Subject(s)
Humans , Male , Adult , Prisoners/psychology , X-Rays , Costs and Cost Analysis , Foreign Bodies/complications , Physical Examination , Indicators of Morbidity and Mortality , Foreign Bodies/therapy
7.
Colomb. med ; 52(2): e4094806, Apr.-June 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1339738

ABSTRACT

Abstract Esophageal trauma is a rare but life-threatening event associated with high morbidity and mortality. An inadvertent esophageal perforation can rapidly contaminate the neck, mediastinum, pleural space, or abdominal cavity, resulting in sepsis or septic shock. Higher complications and mortality rates are commonly associated with adjacent organ injuries and/or delays in diagnosis or definitive management. This article aims to delineate the experience obtained by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia, on the surgical management of esophageal trauma following damage control principles. Esophageal injuries should always be suspected in thoracoabdominal or cervical trauma when the trajectory or mechanism suggests so. Hemodynamically stable patients should be radiologically evaluated before a surgical correction, ideally with computed tomography of the neck, chest, and abdomen. While hemodynamically unstable patients should be immediately transferred to the operating room for direct surgical control. A primary repair is the surgical management of choice in all esophageal injuries, along with endoscopic nasogastric tube placement and immediate postoperative care in the intensive care unit. We propose an easy-to-follow surgical management algorithm that sticks to the philosophy of "Less is Better" by avoiding esophagostomas.


Resumen El trauma esofágico es un evento poco frecuente pero potencialmente mortal. Una perforación esofágica inadvertida puede ocasionar la rápida contaminación del cuello, el mediastino, el espacio pleural o la cavidad abdominal, lo cual puede resultar en sepsis o choque séptico. Las complicaciones y la mortalidad aumentan con el retraso en el diagnóstico o manejo definitivo, y la presencia de lesiones asociadas. El objetivo del presente artículo es describir la experiencia adquirida por el grupo de cirugía de Trauma y Emergencias (CTE) de Cali, Colombia en el manejo del trauma de esófago de acuerdo con los principios de la cirugía de control de daños. Las lesiones esofágicas deben sospecharse en todo trauma toraco-abdominal o cervical en el que el mecanismo o la trayectoria de la lesión lo sugieran. El paciente hemodinámicamente estable se debe estudiar con imágenes diagnósticas antes de la corrección quirúrgica del defecto, idealmente por medio de tomografía computarizada del cuello, tórax y abdomen con contraste endovenoso. Mientras que en el paciente hemodinámicamente inestable se debe explorar y controlar la lesión. El reparo primario es el manejo quirúrgico de elección, con la previa colocación de una sonda nasogástrica y el seguimiento postoperatorio estricto en la unidad de cuidado intensivo. Se propone un algoritmo de manejo quirúrgico que resulta fácil de seguir y adopta la premisa "Menos es Mejor" evitando realizar derivaciones esofágicas.

8.
Arq. gastroenterol ; 58(2): 195-201, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1285325

ABSTRACT

ABSTRACT BACKGROUND: Endoscopic submucosal dissection (ESD) of esophageal superficial neoplasm is associated with a high en bloc R0 resection rate and low recurrence. OBJECTIVE: We aim to compare the performance and clinical outcomes of ESD via ESD after circumferential incision (ESD-C) versus submucosal tunneling (ESD-T). METHODS: Single-center retrospective analysis of all consecutive patients who underwent ESD for superficial esophageal cancer, between 2009 and 2018. ESD-T was defined as the technique of making the mucosal incisions followed by submucosal tunneling in the oral to anal direction. ESD-C consisted of completing a circumferential incision followed by ESD. Main study outcomes included en bloc and R0 resection rates. Secondary outcomes included procedural characteristics, curative resection rate, local recurrence and adverse events. RESULTS: A total of 65 procedures (23 ESD-T and 42 ESD-C) were performed for ESCC (40; 61.5%) and BE-neoplasia (25; 38.5%). There were no statistically significant differences between patients who underwent ESD-T versus ESD-C in en bloc (91.3% vs 100%, P=0.12), R0 (65.2% vs 78.6%, P=0.24), curative resection rates (65.2% vs 73.8%, P=0.47) and mean procedure time (118.7 min with vs 102.4 min, P=0.35). Adverse events for ESD-T and ESD-C were as follows: bleeding (0 versus 2.4%; P=0.53), perforation (4.3% vs 0; P=0.61), esophageal stricture (8.7% versus 9.5%; P=0.31). Local recurrence was encountered in 8.7% after ESD-T and 2.4% after ESD-C (P=0.28) at a mean follow-up of 8 and 2.75 years, respectively (P=0.001). CONCLUSION: ESD-T and ESD-C appear to be equally effective with similar safety profiles for the management of superficial esophageal neoplasms.


RESUMO CONTEXTO: A dissecção endoscópica submucosa (DES) no tratamento da neoplasia superficial do esôfago está associada a uma alta taxa de ressecção R0 em bloco e baixa taxa de recorrência. OBJETIVO: O objetivo deste estudo é comparar o desempenho e os resultados clínicos da DES com incisão circunferencial (DES-C) versus com DES com túnel submucoso (DES-TS). MÉTODOS: Estudo retrospectivo de banco de dados coletados prospectivamente de um centro especializado em DES, investigando pacientes consecutivos submetidos à DES por câncer de esôfago superficial, entre 2009 e 2018. DES-TS foi definida como a técnica de realizar primeiro incisões na mucosa seguida de tunelamento submucoso no sentido oral para anal. DES-C consistiu em completar uma incisão circunferencial seguida da dissecção submucosa. As principais variáveis do estudo incluíram taxas de ressecção em bloco e R0. Os resultados secundários incluíram características do procedimento, taxa de ressecção curativa, recorrência local e eventos adversos. RESULTADOS: Um total de 65 procedimentos (23 DES-TS e 42 DES-C) foram realizados para CCE de esôfago (40; 61,5%) e neoplasia associada ao EB (25; 38,5%). Não houve diferenças estatisticamente significativas entre os pacientes submetidos a DES-TS versus DES-C nas taxas de ressecção em bloco (91,3% vs 100%, P=0,12), R0 (65,2% vs 78,6%, P=0,24), taxas de ressecção curativa (65,2% vs 73,8%, P=0,47) e tempo médio do procedimento (118,7 min com vs 102,4 min, P=0,35). Os eventos adversos para DES-TS e DES-C foram os seguintes: sangramento (0 vs 2,4%; P=0,53), perfuração (4,3% vs 0; P=0,61), estenose esofágica (8,7% vs 9,5%; P=0,31). A recorrência local foi encontrada em 8,7% após DES-TS e 2,4% após DES-C (P=0,28) em um seguimento médio de 8 e 2,75 anos, respectivamente (P=0,001). CONCLUSÃO: DES-TS e DES-C demostram ser igualmente eficazes com perfil de segurança semelhante para o tratamento das neoplasias superficiais do esôfago.


Subject(s)
Humans , Esophageal Neoplasms/surgery , Esophageal Stenosis , Endoscopic Mucosal Resection/adverse effects , Retrospective Studies , Treatment Outcome , Neoplasm Recurrence, Local
9.
Rev. colomb. gastroenterol ; 36(supl.1): 37-41, abr. 2021. graf
Article in Spanish | LILACS | ID: biblio-1251544

ABSTRACT

Resumen Introducción: Los schwannomas esofágicos son tumores de elementos perineurales de la vaina nerviosa de la célula de Schwann en los nervios periféricos y representan el 2 % de los tumores primarios de esófago. Su difícil diagnóstico está dado por la baja incidencia que este presenta; sin embargo, es una etiología que debe considerarse debido a que su comportamiento clínico e imagenológico es rápidamente progresivo e inusual, comparado con otros tumores benignos de esófago. Caso clínico: Paciente femenina de 38 años con cuadro clínico de disfagia de 1 año de evolución, con endoscopia de vías digestivas altas y tomografía axial computarizada (TAC) de tórax contrastada que evidencian una masa a nivel del esófago cervical y torácico transmural, que obstruye la luz y ejerce el efecto de masa sobre la tráquea. Se realizó una biopsia que reportó un tumor fusocelular con inmunohistoquímica positiva para el marcador S100, por lo que se diagnosticó un schwannoma esofágico. En la actualidad, la paciente se encuentra en controles periódicos y en espera del concepto por oncología clínica para proponer tratamiento no quirúrgico dado el compromiso adyacente. Conclusión: Ante la sospecha de tumor primario de esófago, la primera impresión diagnóstica según la incidencia será un leiomioma, pero con nuestro reporte de caso de schwannoma esofágico, se resalta que, en un cuadro clínico no usual, este es un diagnóstico diferencial que requiere atención precoz para evitar complicaciones y secuelas en los pacientes.


Abstract Introduction: Esophageal schwannomas are tumors of the perineural components of the Schwann cell nerve sheath in peripheral nerves and account for 2% of primary esophageal tumors. Its low incidence makes diagnosis challenging; however, this etiology should be considered because its clinical and imaging behavior is rapidly progressive and unusual compared to other benign esophageal tumors. Case study: A 38-year-old female patient with a 1-year history of dysphagia underwent upper digestive tract endoscopy and contrast chest CT showing a mass at the cervical and transmural thoracic esophagus level, obstructing the lumen and exerting a mass effect on the trachea. A biopsy revealed a spindle cell tumor with positive immunohistochemistry for the S100 marker, leading to the diagnosis of esophageal Schwannoma. The patient is currently undergoing regular check-ups and is awaiting the advice of a clinical oncologist to recommend non-surgical treatment options due to the involvement of adjacent structures. Conclusion: The first diagnostic impression in the case of a suspected primary esophageal tumor would be a leiomyoma based on its incidence. The present case report of an esophageal schwannoma emphasizes that this is a differential diagnosis that requires timely treatment to avoid complications and sequelae in patients.


Subject(s)
Humans , Female , Adult , Esophageal Neoplasms , Neurilemmoma , Therapeutics , Endoscopy
10.
Medisan ; 25(2): 265-277, mar.-abr. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1250337

ABSTRACT

Introducción: Los tumores de esófago constituyen lesiones benignas o malignas, que afectan las diferentes capas del órgano. Objetivo: Caracterizar a pacientes con lesiones premalignas de esófago halladas en endoscopia bucal, según variables seleccionadas. Métodos: Se efectuó un estudio observacional, descriptivo y transversal en el Servicio de Gastroenterología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, durante el 2015. El universo estuvo constituido por 57 pacientes de 20 años y más, con diagnóstico endoscópico e histológico de lesión premaligna de esófago. Las variables analizadas fueron: edad, sexo, lesiones premalignas de esófago, grado de esofagitis y diagnóstico histológico. Resultados: La endoscopia mostró un predominio de la esofagitis por reflujo en los pacientes de 62 años y más (61,7 %), así como del grado A de la clasificación de los Ángeles en ambos sexos (39,7 y 30,1 % de mujeres y hombres, respectivamente). Según el diagnóstico histológico primaron la esofagitis crónica (48,4 %) y la esofagitis crónica con displasia (17,1 %). Conclusiones: La identificación de pacientes con lesiones premalignas de esófago constituye el punto de partida para futuras acciones preventivas e intervencionistas, con vistas a disminuir la incidencia del cáncer de esófago.


Introduction: The esophagus malignancies constitute benign or malignant lesions that affect the different layers of the organ. Objective: To characterize patients with esophagus premalignant lesions found in oral endoscopy, according to selected variables. Methods: An observational, descriptive and cross-sectional study was carried out in the Gastroenterology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, during 2015. The universe was constituted by 57 patients aged 20 and over, with endoscopic and histologic diagnosis of esophagus premalignant lesion. The analyzed variables were: age, sex, esophagus premalignant lesions, degree of esophagitis and histologic diagnosis. Results: The endoscopy showed a prevalence of the esophagitis by reflux in patients aged 62 and over (61.7 %), as well as of the grade A of Los Angeles classification in both sexes (39.7 and 30.1% of women and men, respectively). According to the histologic diagnosis there was a prevalence of chronic esophagitis (48.4 %) and chronic esophagitis with dysplasia (17.1 %). Conclusions: The identification of patients with esophagus premalignant lesions constitutes the starting point for future preventive and interventionists actions, aimed at diminishing the incidence of esophagus cancer.


Subject(s)
Esophageal Neoplasms/prevention & control , Endoscopy, Digestive System , Esophageal Diseases/diagnostic imaging , Esophageal Diseases/diagnosis , Esophagitis/diagnostic imaging
11.
Rev. colomb. gastroenterol ; 36(1): 109-114, ene.-mar. 2021. graf
Article in Spanish | LILACS | ID: biblio-1251530

ABSTRACT

Resumen Introducción: la tuberculosis es una enfermedad infecciosa que suele afectar a los pulmones y es causada por Mycobacterium tuberculosis. Se transmite de una persona a otra a través de gotículas generadas en el sistema respiratorio de pacientes con enfermedad pulmonar activa. La tuberculosis esofágica es una afección rara (representa solo el 2,8% de todos los casos de tuberculosis gastrointestinal). Por lo general, ocurre como resultado de la diseminación directa desde los ganglios mediastínicos (rara vez desde los pulmones o el torrente sanguíneo). Su diagnóstico definitivo requiere el aislamiento de los bacilos tuberculosos, lo que rara vez se logra en la práctica clínica; aun así, clínicamente los pacientes presentan síntomas de disfagia, odinofagia y adelgazamiento. Caso clínico: se presenta un paciente de 40 años de edad con cuadro clínico de 6 meses de evolución con disfagia progresiva exacerbada a disfagia para líquidos, astenia, adinamia, hiporexia, dolor pleurítico, epigastralgia y tos con expectoración blanquecina; se realizó una endoscopia de vías digestivas altas que mostró una mucosa gravemente inflamada con ulceraciones irregulares de hasta 2 cm de profundidad, lesiones que sugirieron tuberculosis esofágica, confirmada por el estudio histopatológico: esofagitis crónica granulomatosa; por tanto, se inició el tratamiento tetraconjugado: rifampicina, isoniazida, pirazinamida y etambutol. Conclusiones: La tuberculosis con afección del tubo digestivo es una entidad de baja frecuencia; adicionalmente, es importante recordar que la gravedad del cuadro clínico usualmente está relacionada con la coinfección por el virus de la inmunodeficiencia humana (VIH), y que la asociación de ambas patologías es frecuente.


Abstract Introduction: Tuberculosis is an infectious disease that usually affects the lungs and is caused by Mycobacterium tuberculosis. It is transmitted from one person to another through droplets generated in the respiratory system of patients with active lung disease. Esophageal tuberculosis is a rare condition (accounting for only 2.8% of all cases of gastrointestinal tuberculosis). It usually occurs as a result of the direct spread from the mediastinal nodes, but rarely from the lungs or bloodstream. Its definitive diagnosis requires the isolation of tuberculous bacilli, which is rarely achieved in clinical practice. However, clinically speaking, patients present with symptoms of dysphagia, odynophagia, and weight loss. Case study: This is the case of a 40-year-old patient with symptoms of 6 months of evolution with progressive dysphagia exacerbated to dysphagia for liquids, asthenia, adynamia, hyporexia, pleuritic pain, epigastric pain, and cough with whitish sputum. An endoscopy of the upper digestive tract was performed, showing severely inflamed mucosa with irregular ulcerations up to 2 cm deep, which suggested esophageal TB. The diagnosis was confirmed by histopathology, which reported chronic granulomatous esophagitis. Tetraconjugated treatment was initiated, including rifampicin, isoniazid, pyrazinamide, and ethambutol. Conclusions: Gastrointestinal tuberculosis is a rare entity. It should be noted that the severity of the symptoms is usually associated with HIV co-infection, and their association is a frequent occurrence.


Subject(s)
Humans , Male , Adult , Tuberculosis , HIV , Immunosuppression , Mycobacterium tuberculosis
12.
Arch. méd. Camaguey ; 25(1): e7713, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1152926

ABSTRACT

RESUMEN Fundamento: debido al riesgo de evolución insatisfactoria de los pacientes con esófago de Barrett hacia el adenocarcinoma esofágico, es necesaria la aplicación de técnicas seguras y efectivas que logren prevenir el desenlace hacia lesiones malignas esofágicas. El Hybrid-APC (Argón plasma coagulación) es una de estas técnicas que permiten detener la historia natural del esófago de Barrett en su etapa inicial. Objetivo: realizar una revisión y reflexión acerca del tratamiento endoscópico del esófago de Barrett con el Hybrid-APC. Métodos: se realizó una búsqueda en los motores Google, PudMed, SciELO regional, SciELO Public Health, National Library of Medicine PudMed. En la estrategia de la búsqueda se utilizaron los términos: esófago de Barrett, tratamiento endoscópico, Hybrid-APC. Se evaluaron los documentos en extensos y se desarrolló un documento resumen de la información recolectada. En la búsqueda bibliográfica realizada se encontraron 20 trabajos relacionados con esófago de Barrett, tratamiento endoscópico 10 y específico del uso del Hybrid-APC cinco. Resultados: los estudios reportaron la efectividad y seguridad de la ablación con el Hybrid-APC en el tratamiento endoscópico del esófago de Barrett con displasia de bajo grado; y en la displasia de alto grado y carcinoma in situ remanente, luego de una resección mucosa endoscópica. Conclusiones: el tratamiento endoscópico del esófago de Barrett con Hybrid-APC, se considera una técnica alternativa para detener la evolución de esta enfermedad hacia el adenocarcinoma. Esto generará motivación para entrenamientos y su puesta en práctica de forma generalizada.


ABSTRACT Background: due to the risk of unsatisfactory evolution of patients with Barrett's esophagus (EB) towards esophageal adenocarcinoma, it is necessary to apply safe and effective techniques that prevent the outcome towards esophageal malignant lesions. The Hybrid-APC (argon plasma coagulation) is one of these techniques that allow stopping the natural history of EB in its initial stage. Objective: to conduct a review and reflection on the endoscopic treatment of Barrett's esophagus with the Hybrid-APC. Methods: a search was conducted on Google, PudMed, SciELo regional, SciELo Public Health, National Library of Medicine PudMed engines. The search strategy used the terms: Barrett's esophagus, endoscopic treatment, Hybrid-APC. Extensive documents were evaluated and a summary document of the information collected was developed. The literature search found 20 works related to Barrett's esophagus, ten on endoscopic treatment, and five on specific to the use of Hybrid-APC. Results: studies reported the effectiveness and security of the ablation with the Hybrid-APC in the endoscopic treatment of Barrett's esophagus with low degree dysplasia, and in the high degree dysplasia and remnant carcinoma in situ, after the endoscopic mucous resection. Conclusions: the endoscopic treatment of Barrett's esophagus with Hybrid-APC is considered an alternative technique to stop the evolution of this pathology towards adenocarcinoma. This will generate motivation for training and its implementation in a generalized way.

13.
Horiz. méd. (Impresa) ; 21(1): e1011, ene-mar 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1250046

ABSTRACT

RESUMEN Mujer de 60 años, natural de Tarma y procedente de Lima, con antecedentes de exposición a biomasas, contacto con paciente con tuberculosis, hipertensión arterial, arritmia cardiaca, y madre con cáncer de ovario. La paciente acude a consulta con un cuadro de siete meses de evolución caracterizado por disfagia progresiva, pérdida de peso de 15 kilogramos y fiebre vespertina. En la endoscopía previa mostró un tumor esofágico, y la tomografía reveló un engrosamiento tumoral a nivel de los tercios medio y distal del esófago, dependiente de la pared, y adenopatías mediastinales de 10x10 mm. Los demás órganos torácicos y abdominales no muestran alteraciones. En la última endoscopía se encuentra una lesión ulcerada en esófago y en el estudio patológico se observó una extensa inflamación crónica granulomatosa con células gigantes y necrosis; la prueba de Ziehl Neelsen para el bacilo de Koch (BK) fue negativa sin evidencia de lesión maligna y la reacción en cadena de la polimerasa (PCR) fue positiva para Mycobacterium. Se tomó una biopsia de las adenopatías mediante una ecoendoscopía, con una PCR negativa para Mycobacterium. Concluimos que el cuadro fue una tuberculosis esofágica primaria, y se inició el tratamiento con el esquema específico sensible a una dosis ajustada por peso.


ABSTRACT A 60-year-old woman born in Tarma and living in Lima, with a history of biomass exposure, contact with a patient with tuberculosis, arterial hypertension, heart arrhythmia and mother with ovarian cancer, visited the medical center with progressive dysphagia, 15-kilogram weight loss and evening fever for seven months. A previous endoscopy revealed an esophageal tumor. A CT scan showed middle and distal third esophageal wall thickening, and 10x10 mm mediastinal adenopathies. The rest of the thoracic and abdominal organs were normal. The last endoscopy revealed an ulcerated lesion in the esophagus. The pathological evaluation showed a large chronic granulomatous inflammation with giant cells and necrosis. Ziehl-Neelsen stain was negative for Koch bacillus and revealed no malignant lesion. A Mycobacterium tuberculosis-positive polymerase chain reaction (PCR) was observed. An adenopathy biopsy was performed by endoscopic ultrasound and PCR outcome was negative for Mycobacterium tuberculosis. In conclusion, primary esophageal tuberculosis was diagnosed and a specific treatment with a weight-adjusted dose was initiated.

14.
Rev. Fac. Med. Hum ; 21(1): 171-183, Ene.-Mar. 2021.
Article in English, Spanish | LILACS-Express | LILACS | ID: biblio-1147380

ABSTRACT

Objetivo: El objetivo de este artículo es realizar una revisión sistemática de artículos científicos que revelen los factores de riesgo asociados a Esófago de Barrett en pacientes hospitalizados. Métodos: La revisión fue efectuada mediante búsqueda electrónica de artículos relacionados a factores de riesgo asociadas a Esófago de Barrett en pacientes hospitalizados. La pregunta PEO fue ¿Cuáles son los factores de riesgo asociados a Esófago de Barret en pacientes hospitalizados? Las fuentes de búsqueda fueron en PUBMED. Los términos de búsqueda fueron: Factores de Riesgo; Esófago de Barrett; pacientes hospitalizados. Para esta revisión se seleccionaron los artículos publicados a partir el año 2010 que tuvieron experiencias investigativas y aspectos teórico-conceptuales. Resultados: De los 389 resultados encontrados con fuentes de indexación, se seleccionaron un total de 25 artículos donde 22 artículos contenían resultados de investigación y 3 fueron considerados para aspectos teórico ­ conceptuales que se relacionan con el propósito del estudio. La búsqueda dio como resultado factores de riesgo asociados a Esófago de Barrett según las características demográficas y rasgos del paciente, presentación y datos clínicos y estilos de vida. Conclusión: Se evidencia una asociación de diversos factores de riesgo con Esófago de Barret en pacientes hospitalizados. Los factores de riesgo asociados a Esófago de Barrett en la revisión que fueron más concordantes son sexo masculino, edad incrementada, síndrome metabólico, hernia hiatal, uso de inhibidores de bomba de protones, reflujo gastroesofágico(RGE), apnea obstructiva del sueño y esofagitis erosiva.


Objective: The objective of this article is to carry out a systematic review of scientific articles that reveal the risk factors associated with Barrett's esophagus in hospitalized patients. Methods: The review was performed by electronic search for articles related to risk factors associated with Barrett's esophagus in hospitalized patients. The PEO question was: What are the risk factors associated with Barrett's esophagus in hospitalized patients? The search sources were in PUBMED. The search terms were: Risk Factors; Barrett's esophagus; hospitalized patients. For this review, articles published from 2010 that had research experiences and theoretical-conceptual aspects were selected. Results: Of the 389 results found with indexing sources, a total of 25 articles were selected where 22 articles contained research results and 3 were considered for theoretical-conceptual aspects that are related to the purpose of the study. The search resulted in risk factors associated with Barrett's esophagus according to demographic characteristics and patient traits, presentation, and clinical data and lifestyles. Conclusion: An association of various risk factors with Barrett's esophagus is evidenced in hospitalized patients. The most concordant risk factors associated with Barrett's esophagus in the review were male sex, increased age, metabolic syndrome, hiatal hernia, use of proton pump inhibitors, gastroesophageal reflux (GER), obstructive sleep apnea, and erosive esophagitis.

15.
Autops. Case Rep ; 11: e2021284, 2021. graf
Article in English | LILACS | ID: biblio-1249014

ABSTRACT

Acute esophageal necrosis (AEN), also known as "black esophagus," is an entity characterized by the circumferential black appearance of esophageal mucosa, usually associated with hypoperfusion and gastric outlet obstruction. This entity has a reported prevalence of up to 0.2%, affecting predominantly elderly men with multiple comorbidities. Most cases resolve with conservative treatment with no need of surgical intervention. However, the overall prognosis is poor, with mortality reaching one-third of cases due to the patient's underlying illness. In this article we present three cases of patients with AEN.


Subject(s)
Humans , Male , Middle Aged , Aged , Aged, 80 and over , Esophageal Diseases/pathology , Necrosis , Endoscopy, Gastrointestinal , Gastrointestinal Hemorrhage
16.
ABCD arq. bras. cir. dig ; 34(1): e1528, 2021. tab, graf
Article in English | LILACS | ID: biblio-1248502

ABSTRACT

ABSTRACT Background: Currently, persistent human papillomavirus (HPV) infection has been related in some geographic regions as a risk factor for esophageal squamous cell carcinoma. It results in the immunoexpression of the p16 protein, which has been used as marker of the oncogenic lineage by this etiological agent. Aim: To correlate epidemiological aspects of esophageal squamous cell carcinoma with the prevalence of HPV infection. Methods: Fifty-eight cases were analyzed and submitted to histopathological and immunohistochemical analysis by p16. Results: Of the 58 cases evaluated, 40 were men and 18 women, with a mean age of 63.2 years. p16 immunoexpression was positive in 46.55%. Conclusion: The prevalence of HPV infection is high in esophageal squamous cell carcinoma presenting in almost half of the cases (46.55%), without gender differentiation.


RESUMO Racional: Atualmente a infecção persistente pelo papilomavírus humano (HPV) tem sido relacionada em algumas regiões geográficas como fator de risco para o carcinoma epidermoide do esôfago. Ela resulta na imunoexpressão da proteína p16, que tem sido utilizada como marcadora da linhagem oncogênica por este agente etiológico. Objetivo: Correlacionar aspectos epidemiológicos do carcinoma epidermoide do esôfago com a prevalência de infecção pelo HPV. Métodos: Foram analisados 58 casos buscando-se perfil epidemiológico dos pacientes, com suas peças submetidas à análise histopatológica e imunoistoquímica pelo p16. Resultado: Dos 58 casos avaliados, 40 eram homens e 18 mulheres, com idade média de 63,2 anos. A imunoexpressão pelo p16 foi de 46,55%. Conclusão: A prevalência de infecção pelo HPV é alta no carcinoma epidermoide de esôfago apresentando-se em quase a metade dos casos (46,55%), sem diferenciação de idade quanto aos gêneros.


Subject(s)
Humans , Male , Female , Middle Aged , Esophageal Neoplasms/epidemiology , Carcinoma, Squamous Cell/epidemiology , Papillomavirus Infections/complications , Papillomavirus Infections/epidemiology , Alphapapillomavirus , Esophageal Squamous Cell Carcinoma , Papillomaviridae
17.
Article in Chinese | WPRIM | ID: wpr-909230

ABSTRACT

Objective:To analyze the risk factors of a high demand for perioperative blood transfusion in patients with esophageal and cardiac cancer and to accumulate more evidence-based medicine findings for timely and effective clinical intervention to reduce the volume of blood transfused.Methods:The clinical data of 154 patients with esophageal and cardiac cancer who received treatment from January 2012 to October 2018 in Yuncheng Central Hospital were retrospectively analyzed. Among them, 100 patients who received < 5 U blood transfusion were included in the control group, and 54 patients who received ≥ 5 U blood transfusion were included in the observation group. The causes of a high demand for blood transfusion, the possible influential factors, and their effects on related clinical indicators post-surgery were analyzed.Results:The proportion of patients with underlying diseases, the proportion of patients with anemia pre-surgery, and the amount of blood loss in the observation group were 85.19% (46/54), 48.15% (26/54) and (1 127.92 ± 350.70) mL respectively, which were significantly higher than those in the control group [37.00% (37/100), 21.00% (21/100) and (296.47 ± 98.31) mL, χ2 = 6.17, 7.40, t = 7.54, P < 0.01, P = 0.03, P < 0.01]. The incidence of postoperative complications in the observation group was significantly higher than that in the control group [62.96% (34/54) vs. 33.00% (33/100), χ2 = 9.16, P = 0.00]. There were no significant differences in hospital and intensive care unit lengths of stay between the two groups (both P > 0.05). Platelet count after blood transfusion in the observation group was (190.47 ± 73.48) × 10 12/L, which was significantly higher than (159.00 ± 65.17) × 10 12/L in the control group and (234.31 ± 92.07) × 10 12/L before blood transfusion in the observation group ( t = 4.26, 5.33, both P < 0.01). There were no significant differences in prothrombin time and activated partial thromboplastin time between the two groups (both P > 0.05). In the observation group, the international normalized ratio after blood transfusion was significantly higher than that before blood transfusion [(1.06 ± 0.15) vs. (0.94 ± 0.12), t = 2.78, P = 0.03]. In the observation group, serum K + level after blood transfusion was significantly lower than that before blood transfusion [(3.97 ± 0.42) mmol/L vs. (4.21 ± 0.37) mmol/L, t = 4.01, P < 0.01]. There was no significant difference in serum Ca 2+ level after blood transfusion between the two groups ( P > 0.05). Conclusion:Underlying diseases and anemia are the risk factors for a high demand for blood transfusion in patients with esophageal and cardiac cancer. A high demand for blood transfusion is mainly caused by postoperative bleeding. At the same time, blood transfusion can also increase the risks for abnormal coagulation function, abnormal serum ion levels, and complications post-surgery.

18.
International Journal of Surgery ; (12): 769-773,f4, 2021.
Article in Chinese | WPRIM | ID: wpr-907521

ABSTRACT

Objective:To explore the characteristics of Siewert classification and microsatellite instability(MSI) and HER2 expression in adenocarcinoma of esophagogastric junction (AEG).Methods:The clinicopathological data of gastric adenocarcinoma from May 2019 to November 2020 were retrospectively analyzed. The patients were divided into two groups: AEG group and non AEG group. The composition ratio of Siewert type of AEG was counted, and the relationship between tumor size and Siewert type was analyzed. The MSI status and HER2 expression status of AEG and non AEG were statistically compared. The measurement data of normal distribution were expressed as mean ± standard deviation( Mean± SD), the comparison between groups were by t test, the comparison of count data between groups were by Chi-square test. Results:A total of 328 consecutive cases of gastric adenocarcinoma were collected, including 242 cases of AEG and 86 cases of non AEG. The Siewert classification of AEG was mainly type Ⅱ (151 cases, 62.40%), followed by type Ⅲ (86 cases, 35.54%) and type Ⅰ (5 cases, 2.07%). The analysis of the relationship between the size of the tumor length and the number of Siewert type showed that the number of Siewert type Ⅱ cases decreased and the number of Siewert type Ⅲ cases increased with the increase of the tumor size. MSI status was detected non selectively in 192 cases of gastric adenocarcinoma (140 cases of AEG and 52 cases of non AEG). There were 12 cases of MSI (6.25%), 2 cases of MSI-H (1.04%) and 10 cases of MSI-L (5.21%). There was no significant difference in MSI ratio between AEG group and non AEG group ( P>0.05). All MSI cases were negative or weakly positive for PMS2. The expression of HER2 was detected by immunohistochemistry in 313 cases of gastric adenocarcinoma, except 15 cases of PTIS/T1a. There were 30 cases (9.58%) with HER2 expression 3+ . Thirty-two cases (10.22%) expressed HER2 (2+ ), of which 7 cases were detected by fluorescence in situ hybridization (FISH), and 3 cases were positive. The proportion of HER2 (3+ ) in AEG was significantly higher than that in non AEG group ( P<0.05). Conclusions:The main type of AEG was Siewert type Ⅱ. AEG may mostly occur between 1 cm above the esophagogastric junction and 2 cm below the esophagogastric junction; For endoscopic screening of early AEG, more attention should be paid to this area of stomach. Siewert type Ⅲ may be derived from the development of Siewert type Ⅱ. The incidence of microsatellite instability in gastric cancer is low. Compared with other gastric adenocarcinoma, AEG has no specificity in MSI. The MSI of AEG was mainly the expression defect of PMS2. Compared with other gastric adenocarcinoma, there are more HER2 overexpression in AEG.

19.
Rev. CEFAC ; 23(2): e0821, 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1340664

ABSTRACT

ABSTRACT Objective: to survey the Brazilian participation in original and review articles published in the Dysphagia journal. Methods: original and review articles in volumes 1 to 35, quantifying all those developed in Brazil, the diseases researched, the places where the investigations were conducted, and the number of citations they received, were analyzed. The categorical variables are presented in relative and absolute frequencies. Literature Review: a total of 35 Brazilian manuscripts were published. The most researched disease was Parkinson's, followed by Chagas disease, stroke, and the physiology of swallowing. The highest number of publications was carried out at the Universidade de São Paulo, campus at Ribeirão Preto, SP, and the Universidade Federal de São Paulo, capital city. Between 2001 and 2010, 14 manuscripts were published (3.7% of the journal), and between 2011 and 2020, 20 were published (2.9% of the journal). By 2019, the manuscripts had received 481 citations - 17 citations per article between 1998 and 2009, and 14, between 2010 and 2019. Conclusion: Brazilian manuscripts are regularly published in the Dysphagia journal and have a scientific impact. However, there has not been a progressive increase in the number of published articles.


RESUMO Objetivo: avaliar a participação brasileira em publicações de artigos originais e de revisão na revista Dysphagia. Métodos: foram analisados artigos originais e de revisão do volume 1 ao 35, com quantificação do total de artigos provenientes do Brasil, as doenças pesquisadas, o local onde a pesquisa foi realizada e o número de citações. As variáveis categóricas foram descritas como frequências relativas ou absolutas. Revisão da Literatura: foram publicados 35 trabalhos provenientes do Brasil. Doença de Parkinson foi a doença mais pesquisada, seguida da doença de Chagas, acidente vascular cerebral e fisiologia da deglutição. Universidade de São Paulo, campus de Ribeirão Preto (SP) e a Universidade Federal de São Paulo (SP) foram os locais com maior número de publicações. Entre 2001 e 2010, foram publicados 14 trabalhos (3,7% dos publicados na revista), e de 2011 a 2020 foram 20 (2,9% dos publicados na revista). Até 2019 os trabalhos tiveram 481 citações, sendo 17 citações por artigo entre 1998 e 2009, e 14 citações por artigo entre 2010 e 2019. Conclusão: as publicações de trabalhos brasileiros na revista Dysphagia têm regularidade e impacto, entretanto não houve aumento progressivo no número de artigos publicados.

20.
Autops. Case Rep ; 11: e2021284, 2021. graf
Article in English | LILACS | ID: biblio-1285396

ABSTRACT

Acute esophageal necrosis (AEN), also known as "black esophagus," is an entity characterized by the circumferential black appearance of esophageal mucosa, usually associated with hypoperfusion and gastric outlet obstruction. This entity has a reported prevalence of up to 0.2%, affecting predominantly elderly men with multiple comorbidities. Most cases resolve with conservative treatment with no need of surgical intervention. However, the overall prognosis is poor, with mortality reaching one-third of cases due to the patient's underlying illness. In this article we present three cases of patients with AEN.


Subject(s)
Humans , Male , Middle Aged , Aged , Aged, 80 and over , Esophageal Diseases , Necrosis , Gastrointestinal Hemorrhage , Ischemia
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