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1.
Int. j. morphol ; 41(5): 1336-1342, oct. 2023. ilus
Article in English | LILACS | ID: biblio-1521024

ABSTRACT

SUMMARY: Birds are the most diversified organisms on Earth, with species covering various niches in each major biome, being essential to understand the modern ecosystem. This study concentrates on the diversification of the anatomical structure of the upper digestive tract for 26 species of zoophage-polyphagous birds and the anatomical differences in the digestive system to reveal aspects related to their evolution and diversification. The trophic spectrum of the selected birds includes several categories of food, or, as in the case of strictly carnivorous birds, to a single food category. After performing the dissections, the digestive tract was separated from the carcass and each digestive segment was measured and analysed. In this study, it was demonstrated that the birds' feeding behaviour influence the macroscopic particularities of the digestive system, more visible in the cranial portion (oropharyngeal cavity, esophagus, proventriculus and gizzard), with little descriptive information in the literature. The tongue is poorly developed and immobile in piscivorous birds, while the tongue of insectivorous birds is long and moves considerably away from the tip of the bill. The esophagus was stretchable and presents longitudinal folds on its entire surface in piscivorous species and not extensible in insectivorous birds.


Las aves son los organismos más diversificados de la Tierra, con especies que cubren varios nichos en cada bioma principal, siendo esenciales para comprender el ecosistema moderno. Este estudio se concentra en la diversificación de la estructura anatómica del tracto digestivo superior para 26 especies de aves zoófago-polífagas y las diferencias anatómicas en el sistema digestivo para revelar aspectos relacionados con su evolución y diversificación. El espectro trófico de las aves seleccionadas incluye varias categorías de alimentos o, como en el caso de las aves estrictamente carnívoras, una sola categoría de alimentos. Después de realizar las disecciones, se separó el tracto digestivo de la canal y se midió y analizó cada segmento digestivo. En este estudio se demostró que el comportamiento alimentario de las aves influye en las particularidades macroscópicas del sistema digestivo, más visibles en la porción craneal (cavidad orofaríngea, esófago, proventrículo y molleja), con poca información descriptiva en la literatura. En las aves piscívoras, la lengua está poco desarrollada e inmóvil, mientras que la lengua de las aves insectívoras es larga y se aleja considerablemente de la punta del pico. El esófago era estirable y presentaba pliegues longitudinales en toda su superficie en especies piscívoras y no extensible en aves insectívoras.


Subject(s)
Animals , Birds/anatomy & histology , Upper Gastrointestinal Tract/anatomy & histology , Proventriculus , Biodiversity , Esophagus/anatomy & histology , Gizzard, Avian , Anatomy, Comparative
2.
Rev. colomb. cir ; 38(4): 735-740, 20230906. fig
Article in Spanish | LILACS | ID: biblio-1511131

ABSTRACT

Introducción. La ingesta de cáusticos continúa siendo un problema de salud pública en los países en vía de desarrollo, por lo que a veces es necesario realizar un reemplazo esofágico en estos pacientes. Aún no existe una técnica estandarizada para este procedimiento. Caso clínico. Masculino de 10 años con estenosis esofágica por ingesta de cáusticos, quien no mejoró con las dilataciones endoscópicas. Se realizó un ascenso gástrico transhiatal por vía ortotópica mediante cirugía mínimamente invasiva como manejo quirúrgico definitivo .Discusión. Actualmente existen varios tipos de injertos usados en el reemplazo esofágico. La interposición colónica y gástrica son las que cuentan con mayores estudios, mostrando resultados similares. Conclusiones. La elección del tipo y posición del injerto debe ser individualizada, tomando en cuenta las características de las lesiones y la anatomía de cada paciente para aumentar la tasa de éxito.


Introduction. The ingestion of caustics continues to be a public health problem in developing countries, which is why sometimes is necessary to perform an esophageal replacement in these patients. There is still no standardized technique for this procedure. Clinical case. A 10-year-old male with esophageal stricture due to caustic ingestion, who did not improve with endoscopic dilations. A laparoscopic transhiatal gastric lift was performed orthotopically as definitive surgical management using minimally invasive surgery. Discussion. Currently there are several types of grafts used in esophageal replacement. Colonic and gastric interposition are the ones that have the most studies, showing similar results. Conclusions. Choice of type and position of the graft must be individualized, taking into account the characteristics of the lesions and anatomy of each patient, in order to increase the success rate.


Subject(s)
Humans , Pediatrics , Caustics , Esophagectomy , Esophageal Diseases , Esophageal Stenosis , Esophagus
3.
Rev. venez. cir ; 76(2): 90-96, 2023. ilus, tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1553847

ABSTRACT

El dominio de procedimientos avanzados en laparoscopia es fundamental para los cirujanos, por ello el entrenamiento es imprescindible. La miotomía de Heller y funduplicatura de Dor requieren el desarrollo de habilidades y destrezas para realizar la cirugía de forma segura y eficaz, superar la curva de aprendizaje es un reto para el cirujano en formación, por lo que se propone el esófago porcino como modelo ex vivo de entrenamiento laparoscópico, con el fin de permitir desarrollar las habilidades necesarias y así llevar a cabo con éxito el procedimiento quirúrgico.Objetivo : Aplicar el esófago porcino como modelo ex vivo para el entrenamiento laparoscópico de la miotomía de Heller y funduplicatura de Dor.Métodos : Se realizó un estudio prospectivo, experimental y longitudinal, aplicado en un período de 17 semanas, en sesiones de 1 hora cada una, una sesión por semana.Resultados : Se llevaron a cabo 17 prácticas realizadas por el autor, evaluadas por cirujanos expertos, observando un aumento de la puntuación obtenida en la escala GOALS y disminución del tiempo de ejecución a medida que aumentaba el número de prácticas con una correlación altamente significativa, según la tau-B de Kendall (p=0,000).Conclusión : El modelo ex vivo permitió recrear la mayoría de los pasos quirúrgicos y demostró ser una herramienta útil y valiosa, disminuyendo el tiempo de ejecución del procedimiento y aumentando significativamente las habilidades laparoscópicas(AU)


Mastery of advanced procedures in laparoscopy is important for surgeons, therefore training is essential. Heller's myotomy and Dor's fundoplication require the development of abilities and skills to perform the surgery safely and effectively, overcoming the learning curve is a challenge for the surgeon in training, so the porcine esophagus is proposed as an ex vivo model of laparoscopic training in order to develop the necessary skills to successfully carry out the surgical procedure. Objective: To apply the porcine esophagus as an ex vivo model for laparoscopic training of Heller's myotomy and Dor's fundoplication. Methods: A prospective, experimental and longitudinal study was carried out, applied by the authors in a period of 17 weeks, in sessions of 1 hour each, one session per week. Results: 17 practices carried out by the author were carried out, evaluated by expert surgeons, observing an increase in the score obtained on the GOALS scale and a decrease in execution time as the number of practices with a high significant influence increase, according to Kendall's tau-B (p=0.000). Conclusion: The ex vivo model allowed recreating most of the surgical steps and stood out as a useful and valuable tool, decreasing the execution time of the procedure and significantly increasing laparoscopic skills(AU)


Subject(s)
Animals , Swine , Laparoscopy , Esophagus/anatomy & histology , Simulation Training , Heller Myotomy/instrumentation , General Surgery
4.
Acta cir. bras ; 38: e381723, 2023. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1429536

ABSTRACT

Purpose: The effects of hesperidin application on the wound caused by esophageal burns were investigated in this study. Methods: Wistar albino rats were divided into three groups: Control group: only 1 mL of 0.09% NaCl was administered i.p. for 28 days; Burn group: An alkaline esophageal burn model was created with 0.2 mL of 25% NaOH orally by gavage­1 mL of 0.09% NaCl was administered i.p. for 28 days; Burn+Hesperidin group: 1 mL of 50 mL/kg of hesperidin was given i.p. for 28 days to rats after burn injury. Blood samples were collected for biochemical analysis. Esophagus samples were processed for histochemical staining and immunohistochemistry. Results: Malondialdehyde (MDA) and myeloperoxidase (MPO) levels were significantly increased in Burn group. Glutathione (GSH) content and histological scores of epithelialization, collagen formation, neovascularization was decreased. After hesperidin treatment, these values were significantly improved in the Burn+Hesperidin group. In the Burn group, epithelial cells and muscular layers were degenerated. Hesperidin treatment restored these pathologies in Burn+Hesperidin group. Ki-67 and caspase-3 expressions were mainly negative in control group; however, the expression was increased in the Burn group. In the Burn+Hesperidin group, Ki-67 and caspase-3 immune activities were reduced. Conclusion: Hesperidin dosage and application methods can be developed as an alternative treatment for burn healing and treatment.


Subject(s)
Wound Healing/drug effects , Apoptosis , Ki-67 Antigen , Esophagus/injuries , Caspase 3 , Hesperidin/administration & dosage , Burns
5.
Journal of Zhejiang University. Science. B ; (12): 455-457, 2023.
Article in English | WPRIM | ID: wpr-982385

ABSTRACT

Chest pain is one of the most common complaints in the emergency department. Diseases of the heart, aorta, lungs, esophagus, stomach, mediastinum, pleura, and abdominal viscera can all cause chest discomfort (Gulati et al., 2021; Jiao et al., 2021; Lu et al., 2022). Clinicians in the emergency department are expected to immediately recognize life-threatening chest pain (Jiao et al., 2021). Delayed diagnosis further increases the risk of complications and mortality (Liu et al., 2021). In this case, we present an elderly Chinese female who had a history of myocardial infarction two years previously, with chest pain eventually found to be caused by ingestion of a duck bone.


Subject(s)
Humans , Female , Aged , Esophagus , Foreign Bodies/diagnosis , Chest Pain/complications , Emergency Service, Hospital , Heart
6.
Braz. j. biol ; 83: 1-10, 2023. ilus, graf
Article in English | LILACS, VETINDEX | ID: biblio-1468816

ABSTRACT

The work aims were to describe the histological and histochemical structure of the gastroesophageal tube of Iguana iguana and verify the occurrence and distribution of immunoreactive serotonin (5-HT) and somatostatin (SS) cells. Fragments of the gastrointestinal tract (GIT) of five iguanas were which underwent standard histological and immunohistochemistry technique. Immunoreactive cells for 5-HT and SS were quantified using the STEPanizer. The oesophagus has ciliated columnar pseudostratified epithelium with staining Alcian blue (AB) + and goblet cells highly reactive to periodic acid Schiff (PAS). In the cervical oesophagus, the numerical density of 5-HT cells per unit area (QA [5-HT cells]/µm2) was 4.6x10-2 ± 2.0 and celomatic oesophagus presented QA = 4.0x10-2 ± 1.0. The epithelium of the stomach is simple columnar, PAS and AB +. The cranial and middle regions of the stomach presented (QA [5-HT cells]/µm2) = 6.18x10-2 ± 3.2 and the caudal region, QA = 0.6x10-2 ± 0.2. The SS cells were only observed in the caudal stomach, with numerical density (QA [SS cells]/µm2) = 1.4x10-2 ± 0.9 In I. iguana, variation was observed in terms of the distribution of mucus secretions and the pattern of occurrence of serotonin and somatostatin-secreting enteroendocrine cells in the TGI, which possibly will result in an interspecific adaptive response.


Os objetivos do trabalho foram descrever a estrutura histológica e histoquímica do tubo gastroesofágico da Iguana iguana e verificar a ocorrência e distribuição de células serotonina (5-HT) e somatostatina (SS) imunorreativas. Fragmentos do trato gastrointestinal (TGI) de cinco iguanas foram submetidos à técnica histológica e imunohistoquímica padrão. As células imunorreativas para 5-HT e SS foram quantificadas usando o STEPanizer. O esôfago apresenta epitélio pseudoestratificado colunar ciliado Alcian blue (AB) positivo, com células caliciformes altamente reativas ao ácido periódico de Schiff (PAS). No esôfago cervical, a densidade numérica de células 5-HT por unidade de área (QA [células 5-HT] / µm2) foi de 4.6x10-2 ± 2.0 e o esôfago celomático apresentou QA = 4.0x10-2 ± 1.0. O epitélio do estômago é colunar simples, PAS e AB positivo. As regiões cranial e média do estômago apresentaram (QA [células 5-HT] / µm2) = 6.18x10-2 ± 3.2 e a região caudal, QA = 0.6x10-2 ± 0.2. As células SS foram observadas apenas no estômago caudal, com densidade numérica (QA [células SS] / µm2) = 1.4x10-2 ± 0.9. Em I. iguana, foi observada variações em termos da distribuição das secreções de muco e padrão de ocorrência das células enteroendócrinas secretoras de serotonina e somatostatina no TGI, o que possivelmente reflete uma resposta adaptativa interespecifica.


Subject(s)
Animals , Stomach , Esophagus , Iguanas/anatomy & histology , Immunohistochemistry/veterinary , Serotonin/analysis , Somatostatin/analysis , Gastrointestinal Tract/anatomy & histology
7.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery ; (12): 52-58, 2023.
Article in Chinese | WPRIM | ID: wpr-971407

ABSTRACT

Objective: To explore the indications and management of common postoperative complications of phase II tracheoesophageal puncture (TEP) for Provox Vega voice prosthesis after total laryngectomy. Methods: The clinical data of 20 patients undergoing phase II TEP for Provox Vega voice prosthesis in our hospital between May 2021 and January 2022 were analyzed. Among them, there were 19 males and 1 female, aged from 37 to 76 years, with an average age of (60.0±8.4)years. The surgical indications and the prevention and treatment of common postoperative complications were summarized. Descriptive analysis was used in this research. Results: The basic surgical indications were as following: after total laryngectomy, there was no stenosis of the stoma and esophagus entrance, no scar constitution, no mouth opening restriction, no stiffness and backward restraint of the neck after radiotherapy, and more than half a year apart surgery or radiotherapy. Among the 20 patients, 18 underwent implantation successfuly, 1 failed in the operation, and for 1 patient, the prosthesis was removed due to bleeding 1 week after implantation. The common postoperative complications included TEP fistula infection (2 cases), the TEP fistula bleeding(1 case), deep neck (prevertebral) abscess (1 case), granulation at the inner side of the TEP fistula (1 case), invagination of the prosthesis (2 cases) and leakage around the prosthesis (2 cases). All patients were cured with different interventions. Conclusions: The Provox Vega voice prosthesis is generally safe for phase Ⅱ implantatione, but implantation indications need to be established. Common postoperative complications can be solved through preventive and remedial interventions.


Subject(s)
Male , Humans , Female , Larynx, Artificial/adverse effects , Laryngectomy/adverse effects , Prosthesis Implantation/adverse effects , Esophagus/surgery , Postoperative Complications/etiology , Prosthesis Design
8.
Med. lab ; 27(1): 39-44, 2023. ilus
Article in Spanish | LILACS | ID: biblio-1413055

ABSTRACT

La esofagitis eosinofílica (EoE) es una enfermedad causada por una respuesta inmune frente a antígenos alimentarios en contacto con la mucosa esofágica; por su parte, la enfermedad de Von Willebrand (EVW) es el trastorno hemorrágico hereditario más común en los seres humanos. La característica central de todos los tipos de EVW, es la presencia de cantidades reducidas o de formas anormales del factor de Von Willebrand (FVW) en el torrente sanguíneo. Debido a que no se han reportado casos previos de EVW tipo 2A asociada a EoE, se describe este caso clínico con el objetivo principal de dar a conocer el hallazgo casual de estas dos patologías, la seguridad de la evaluación por endoscopia de vías digestivas altas y el pronóstico de posibles complicaciones


Eosinophilic esophagitis (EoE) is a disease caused by an immune response against food antigens in contact with the esophageal mucosa; alternatively, Von Willebrand disease (VWD) is the most common inherited bleeding disorder in humans. The central characteristic of all types of VWD is the presence of reduced amounts or abnormal forms of VWF in the bloodstream. Since no previous cases of VWD type 2A associated to EoE have been reported, this clinical case is described with the main objective to present the coincidental finding of these two pathologies, the safety of the evaluation by upper gastrointestinal endoscopy, and the prognosis of possible complications


Subject(s)
Humans , Male , Young Adult , von Willebrand Diseases/complications , Eosinophilic Esophagitis/complications , Eosinophilic Esophagitis/diagnosis , Biopsy/adverse effects , Endoscopy, Digestive System/adverse effects , Esophagus/pathology , Eosinophilic Esophagitis/pathology , Gastrointestinal Hemorrhage/prevention & control
9.
Rev. argent. cir ; 114(4): 355-358, oct. 2022. graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1422948

ABSTRACT

RESUMEN Los cuerpos extraños en el esófago son un problema frecuente en urgencias, debido la mayoría de las veces a ingestión accidental. Presentamos el caso de una paciente femenina de 50 años, sin antecedentes patológicos, que consulta por presentar la ingesta de prótesis dental mientras almorzaba, con posterior disfagia, odinofagia y dolor cervical. Se le realizan radiografías y tomografía computarizada (TC) donde se evidencia imagen radiopaca en esófago cervical. Se interconsulta con el Servicio de Gastroenterología, dada la imposibilidad de extracción de la prótesis por vía endoscópica. Se realiza luego cervicotomía lateral izquierda de emergencia, con esofagotomía, extracción del cuerpo extraño y cierre primario del esófago. La obstrucción del esófago por cuerpos extraños puede ocasionar muchas complicaciones. La consecuente demora en el tratamiento puede llevar a un marcado aumento de la mortalidad. Por eso, en este caso, se prioriza la cirugía ante un riesgo elevado de perforación y hemorragia.


ABSTRACT Esophageal foreign bodies are a common problem in the emergency department, usually due to accidental ingestion. We report the case of a 50-year-old otherwise healthy female patient who sought medical care due to dysphagia, odynophagia and cervical pain after swallowing a partial denture while having lunch. The patient underwent X-rays and a computed tomography (CT) scan which showed a radiopaque image in the upper esophagus. After a failed attempt to remove the denture through endoscopy, surgery was decided via a left lateral emergency cervicotomy with esophagotomy, foreign body removal and primary closure of the esophagus. Esophageal obstruction due to foreign bodies may cause many complications. Treatment delays may result in increased mortality. Thus, in this case we prioritized surgery due to high risk of perforation and bleeding.


Subject(s)
Humans , Female , Middle Aged , Esophagostomy , Esophagus , Foreign Bodies , Denture, Partial , Endoscopy
10.
Rev. cuba. cir ; 61(3)sept. 2022.
Article in Spanish | LILACS, CUMED | ID: biblio-1441515

ABSTRACT

Introducción: Las perforaciones del esófago cervical por traumas externos son lesiones raras asociadas con una morbilidad significativa. Los mecanismos primarios son los traumatismos penetrantes por heridas de bala, cerca del 80 por ciento de los casos, seguidas de las heridas con armas cortopunzantes en el 15 al 20 por ciento. Objetivo: Describir los criterios actuales sobre la conducta y enfoque terapéutico ante el trauma penetrante de esófago cervical. Métodos: Se realizó revisión descriptiva narrativa, de fuentes primarias y secundarias que abordaron el tema durante el primer semestre del año 2021. Los criterios de selección de los artículos a examinar fueron determinados, entre otros, por el objetivo de la actual revisión. Desarrollo: El estándar diagnóstico para estas lesiones, en ausencia de inestabilidad hemodinámica, se basó en estudios como el esofagograma, la endoscopia y la tomografía. La reparación primaria con o sin reforzamiento fue la opción más utilizada, aunque las condiciones locales y tipo de lesión en esófago cervical marcan en gran medida el proceder a realizar. Conclusiones: Las lesiones traumáticas del esófago cervical son raras pero muy mórbidas. El tratamiento depende de la ubicación de la perforación y cualquier lesión concurrente. La mayoría de los casos son susceptibles de reparación primaria con refuerzo de colgajo. Otros principios del tratamiento incluyen el drenaje adecuado alrededor de la reparación, la descompresión del esófago y el estómago (mediante sonda nasogástrica o sonda de gastrostomía) y nutrición enteral distal (yeyunostomía de alimentación). El cirujano ha de ser incisivo en los esfuerzos por descubrir la lesión de forma temprana y manejarla adecuadamente(AU)


Introduction: Cervical esophageal perforations for external trauma are rare injuries associated with a significant morbidity. The primary mechanisms are penetrating trauma for gunshot wounds, accounting for about 80 percent of cases, followed by sharp weapon injuries, accounting for 15 percent to 20 percent. Objective: To describe the current criteria on the behavior and therapeutic approach to cervical esophageal penetrating trauma. Methods: A descriptive narrative review was carried out of primary and secondary sources that addressed the subject during the first semester of the year 2021. The selection criteria of the articles to be examined were determined, among others, by the objective of the current review. Development: The standard diagnosis for these lesions, in the absence of hemodynamic instability, was based on studies such as esophagogram, endoscopy and tomography. Primary repair with or without reinforcement was the most commonly used option, although local conditions and type of lesion in cervical esophagus largely mark the procedure to be performed. Conclusions: Traumatic cervical esophageal injuries are rare but very morbid. Their treatment depends on the location of the perforation and any concurrent injury. Most cases are amenable to primary repair with flap reinforcement. Other principles of treatment include adequate drainage around the repair, decompression of the esophagus and stomach (by nasogastric tube or gastrostomy tube), as well as distal enteral nutrition (feeding jejunostomy). The surgeon must be incisive in efforts to discover the injury early and manage it appropriately(AU)


Subject(s)
Humans , Male , Wounds, Penetrating/etiology , Jejunostomy/methods , Esophageal Perforation , Esophagus/injuries , Epidemiology, Descriptive , Endoscopy/methods
11.
Rev. cir. (Impr.) ; 74(3): 240-247, jun. 2022. ilus, tab
Article in Spanish | LILACS | ID: biblio-1407917

ABSTRACT

Resumen Objetivo: Describir resultados de la cirugía de sustitución esofágica con tubo gástrico invertido, vía ascenso retroesternal en dos hospitales pediátricos durante el período marzo 2015 a marzo 2018. Materiales y Método: Un estudio observacional, transversal, con recolección de datos retrospectivo, donde se incluyeron todos los expedientes de pacientes que presentaban patología del esófago por causa adquirida o congénita que fueron operados de sustitución esofágica con tubo gástrico invertido en dos hospitales pediátricos durante 3 años. Resultados: Encontramos 29 niños sometidos a sustitución esofágica, de los cuales 27 cumplieron criterios de inclusión. La edad comprendida entre 2 y 17 años. El 63% corresponde al sexo femenino. La causa más frecuente de sustitución esofágica es por estenosis esofágica por ingesta caustica (92,59%). El 70% presentó algún tipo de complicación luego de la cirugía. La fístula esofagocutánea es la complicación principal con 33,33%. La permanencia en la unidad de cuidados intensivos es menor de 24 horas en un 74% de los niños. Se inicia la vía oral en casi la mitad de casos entre los 10-12 días de posquirúrgico, la estancia hospitalaria es en promedio 18,5 días. La mortalidad es 3,7%. Conclusión: La sustitución esofágica por tubo gástrico invertido vía ascenso retroesternal, es una técnica comparable en resultados a la interposición de colón. Para los autores, el estómago es un órgano ideal para realizar la reconstrucción esofágica, y sus complicaciones son manejables.


Aim: To describe the results of esophageal replacement surgery with an inverted gastric tube via retrosternal ascent in two pediatric hospitals during the period March 2015 to March 2018. Materials and Method: an observational, cross-sectional study with retrospective data collection that included all the records of patients with esophageal discontinuity due to acquired or congenital causes who underwent esophageal replacement surgery with an inverted gastric tube in two pediatric hospitals for 3 years. Results: We found 29 children undergoing esophageal replacement, of which 27 met inclusion criteria. The age between 2 to 17 years. 63% corresponds to the female sex. The most frequent cause of esophageal replacement is esophageal stricture due to caustic ingestion (92.59%). 70% presented some type of complication after surgery. The esophagocutaneous fistula is the main complication with 33.33%. The stay in the intensive care unit is less than 24 hours in 74% of children. The oral route is started in almost half of cases between 10-12 days after surgery; the hospital stay is on average 18.5 days. Mortality is 3.70%. Conclusión: The esophageal substitution by inverted gastric tube via retrosternal ascent is a technique comparable in results to the interposition of the colon. For the authors, the stomach is an ideal organ to perform esophageal reconstruction, and its complications are manageable.


Subject(s)
Humans , Male , Female , Child , Adolescent , Colon/surgery , Esophageal Atresia/surgery , Esophagoplasty/methods , Postoperative Complications , Stomach/surgery , Anastomosis, Surgical/methods , Demography , Esophageal Stenosis , Esophagus/surgery
12.
Rev. méd. Maule ; 37(1): 89-92, jun. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1397745

ABSTRACT

Zenker's diverticulum develops in the hypopharynx, usually between the cricopharyngeus muscle and the inferior pharyngeal constrictor muscle, at the level of the C5 and C6 vertebrae. It often manifests clinically with dysphagia, persistent reflux, and halitosis. Its reference diagnosis is through barium video swallowing observed by fluoroscopy. Management is surgical with a cervical or transoral approach, the latter having a better safety profile


Subject(s)
Humans , Male , Aged , Zenker Diverticulum/diagnostic imaging , Esophagus/diagnostic imaging , Radiography , Tomography, X-Ray Computed , Esophageal Fistula/diagnostic imaging , Zenker Diverticulum/surgery , Zenker Diverticulum/physiopathology , Zenker Diverticulum/epidemiology
13.
Rev. colomb. gastroenterol ; 37(1): 78-81, Jan.-Mar. 2022. tab, graf
Article in English | LILACS | ID: biblio-1376908

ABSTRACT

Abstract A report of two cases of esophageal intramural pseudodiverticulosis, a very unusual disease, with other 240 cases reported in the entire world literature since 1960. Its etiology and pathogenesis are still not fully understood. However, it is believed that hypertrophy of the submucosal glands, with chronic inflammation, fibrosis, and consequent esophageal stenosis, causes dysphagia, which is the primary manifestation of esophageal intramural pseudodiverticulosis. The main diagnostic methods include the radiological examination of the esophagus with barium contrast (esophagogram) and esophagogastroduodenoscopy (EGD). Both reported cases were treated with endoscopic dilation, exemplifying the safety and efficacy of this therapeutic option for treating dysphagia in these individuals.


Resumen Reporte de dos casos de pseudodiverticulosis esofágica intramural, una enfermedad muy inusual, con otros 240 casos reportados en toda la literatura mundial desde 1960. Su etiología y patogenia aún no se conocen completamente; sin embargo, se cree que existe una hipertrofia de las glándulas submucosas, con inflamación crónica, fibrosis y consecuente estenosis esofágica, lo que provoca disfagia, que es la principal manifestación de la pseudodiverticulosis esofágica intramural. El examen radiológico del esófago con contraste de bario (esofagograma) y la endoscopia digestiva alta (EDA) son los principales métodos de diagnóstico. Ambos casos reportados se trataron con dilatación endoscópica, lo que ejemplifica la seguridad y eficacia de dicha opción terapéutica para el tratamiento de la disfagia en estos individuos.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Deglutition Disorders , Diverticulosis, Esophageal , Dilatation , Endoscopy , Esophagus , Disease , Hypertrophy
14.
Ciênc. Saúde Colet. (Impr.) ; 27(3): 1157-1170, mar. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364677

ABSTRACT

Abstract This study aimed to analyze the role of period, geographic and socio demographic factors in cancer-related mortality by prostate, breast, cervix, colon, lung and esophagus cancer in Brazilians capitals (2000-2015). Ecological study using data of Brazilian Mortality Information. Multilevel Poisson models were used to estimate the adjusted risk of cancer mortality. Mortality rate levels were higher in males for colon, lung and esophageal cancers. Mortality rates were highest in the older. Our results showed an increased risk of colon cancer mortality in both sexes from 2000 to 2015, which was also evidenced for breast and lung cancers in women. In both genders, the highest mortality risk for lung and esophageal cancers was observed in Southern capitals. Midwestern, Southern and Southeastern capitals showed the highest mortality risk for colon cancer both for males and females. Colon cancer mortality rate increased for both genders, while breast and lung cancers mortality increased only for women. The North region showed the lowest mortality rate for breast, cervical, colon and esophageal cancers. The Midwest and Northeast regions showed the highest mortality rates for prostate cancer.


Resumo Este estudo teve como objetivo analisar o papel de fatores temporais, geográficos e sociodemográficos na mortalidade por câncer de próstata, mama, colo do útero, cólon, pulmão e esôfago nas capitais brasileiras (2000-2015). Estudo ecológico utilizando informações brasileiras de mortalidade. Modelos de Poisson multinível foram usados ​​para estimar o risco ajustado de mortalidade por câncer. Os níveis de mortalidade foram maiores em homens para câncer de cólon, pulmão e esôfago. As taxas de mortalidade foram mais altas nos idosos. Nossos resultados mostraram risco aumentado de mortalidade por câncer de cólon em ambos os sexos de 2000 a 2015, o que também foi evidenciado para câncer de mama e de pulmão em mulheres. Em ambos os sexos, o maior risco de mortalidade para câncer de pulmão e esôfago foi observado nas capitais do Sul. As capitais do Centro-Oeste, Sul e Sudeste apresentaram o maior risco de mortalidade por câncer de cólon tanto para homens quanto para mulheres. A taxa de mortalidade por câncer de cólon aumentou para ambos os sexos, enquanto a mortalidade por câncer de mama e de pulmão aumentou apenas para as mulheres. A região Norte apresentou a menor taxa de mortalidade por câncer de mama, colo do útero, cólon e esôfago. As regiões Centro-Oeste e Nordeste apresentaram as maiores taxas de mortalidade por câncer de próstata.


Subject(s)
Breast Neoplasms/epidemiology , Prostate , Cervix Uteri , Colon , Esophagus , Multilevel Analysis , Lung
15.
Acta otorrinolaringol. cir. cuello (En línea) ; 50(2)20220000. ilus, tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1382342

ABSTRACT

Introducción: la heterotopia de mucosa gástrica del esófago proximal (HMGEP) es una entidad clínica poco entendida y probablemente subdiagnosticada, que consiste en la presencia de islas de mucosa gástrica ectópica en el esófago proximal. Caso clínico: presentamos el caso de un neonato que presenta de manera temprana estridor y distrés respiratorio secundario a mucosa redundante en la región poscricoidea, que prolapsa sobre la supraglotis y ocluye la luz de la vía aérea. El estudio histopatológico reporta HMGEP. Se realiza una terapia ablativa con láser, con lo cual la paciente se recupera paulatinamente. Metodología: se llevó a cabo una amplia búsqueda de la literatura de HMGEP en las bases de datos PubMed, SciELO, Mendeley y Elsevier, en idioma inglés y español, desde 1980 a 2021 y se incluyeron 18 artículos en total. Discusión: la HMGEP suele ser una entidad asintomática que en ocasiones genera síntomas faringolaríngeos, y de manera infrecuente puede asociarse con complicaciones como estenosis, úlceras, perforación esofágica e incluso obstrucción de la vía aérea como en el presente caso. Conclusiones: además de las diversas alteraciones en la vía aérea que pueden generar estridor y dificultad respiratoria en niños, debemos descartar causas gastroesofágicas subyacentes asociadas con estas manifestaciones, como la HMGEP.logos y expertos en radioterapia permite obtener buenos resultados quirúrgicos y clínicos en la inmensa mayoría de casos.


Introduction: Gastric mucosal heterotopia of the proximal esophagus (HMGEP) is a poorly understood and probably underdiagnosed clinical entity that consists of the presence of islands of ectopic gastric mucosa in the proximal esophagus. Clinical Case: In this article, we present the case of a newborn who started with early stridor and respiratory distress secondary to redundant mucosa in the postcricoid region that prolapsed over the supraglottis, occluding the airway lumen. The histopathological study reports HMGEP. Ablative laser therapy is performed with which the patient gradually recovers. Methodology: An extensive search of the HMGEP literature was conducted in PubMed, SciELO, Mendeley, and Elsevier data base; in English and Spanish, from 1980 to 2021, including a total of 18 articles. Discussion: HMGEP is usually an asymptomatic entity that sometimes causes pharyngolaryngeal symptoms and, infrequently, can be associated with complications such as stenosis, ulcers, esophageal perforation, and even airway obstruction, as in the present case. Conclusions: In addition to the various alterations in the airway that can generate stridor and respiratory distress in children, we must rule out underlying gastroesophageal causes associated with these manifestations, such as HMGEP.


Subject(s)
Humans , Esophagus , Choristoma
16.
Rev. Méd. Inst. Mex. Seguro Soc ; 60(1): 75-79, 2022. tab, ilus
Article in Spanish | LILACS | ID: biblio-1361665

ABSTRACT

Introducción: el pénfigo vulgar comprende un grupo de enfermedades heterogéneas autoinmunes ampollosas de la piel y las mucosas. La afectación esofágica en el pénfigo vulgar es rara, con una prevalencia incierta que requiere un abordaje diagnóstico y terapéutico detallado. Caso clínico: mujer de 37 años, con antecedentes de tratamiento con inhibidores de la Cox-2 debido a hernia discal. Se envió a Gastroenterología por pérdida de peso de aprox. 5kg en un mes. La paciente tuvo presencia de disfagia, odinofagia y dolor retroesternal con pobre tolerancia a la vía oral. Se hizo endoscopía que reportó esofagitis disecante superficial y gastropatía eritematosa de antro; el duodeno estaba en estado normal. Los hallazgos se correlacionaron con el diagnóstico de pénfigo vulgar con afectación exclusiva a esófago. En la valoración no se identificaron lesiones en piel, cavidad oral u otras mucosas. Se hizo nueva endoscopía como control y se encontró inmunofluorescencia de biopsia esofágica reactiva a IgG 2. Se dio manejo inicial con glucocorticoides, antiinflamatorios e inmunosupresores. Conclusiones: la importancia del estudio del pénfigo radica no solo en la alta morbimortalidad asociada, sino en lo raro y complejo de su detección, pues los pacientes suelen tardar varios meses en tener un diagnóstico certero y aún más en conseguir las metas terapéuticas. Es prioritaria la difusión del estudio del pénfigo entre los profesionales de lasalud involucrados en su detección.


Background: Pemphigus vulgaris comprises a group of heterogeneous blistering autoimmune diseases of the skin and mucosa. Esophageal involvement within pemphigus vulgaris is rare with an uncertain prevalence that requires a detailed diagnostic and a therapeutic approach. Clinical case: 37-year-old female, with a history of treatment with Cox-2 inhibitors due to herniated disc. She is sent to the Gastroenterology Service for weight loss of approximately 5 kilos in a month, with the presence of dysphagia, odynophagia and retrosternal pain with poor toleranceto the oral route. Endoscopy was performed, which reported esophagitis dissecans superficialis (EDS), erythematous gastropathy of the antrum and normal duodenum. Findings were correlated with the diagnosis ofpemphigus vulgaris with exclusive involvement of the esophagus. The evaluation did not identify lesions on the skin, oral cavity or other mucous membranes. A new endoscopy was performed as a control and it was found immunofluorescence of the esophageal biopsy reactive to IgG 2. Initial management was given with glucocorticoids, anti-inflammatories and immunosuppressants. Conclusions: The importance of the study ofpemphigus lies not only in the high associated morbidity and mortality, but also in its intrinsic rarity and the complexity of its detection, given that patients usually take several months to have an accurate diagnosis and even more time to achieve therapeutic goals. It is a priority the dissemination of the study of pemphigus among health professionals involved in its detection.


Subject(s)
Humans , Female , Adult , Endoscopy, Gastrointestinal , Pemphigus , Autoimmune Diseases , Diagnostic Imaging , Esophagus
17.
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
18.
Int. j. morphol ; 40(2): 436-441, 2022. ilus
Article in Spanish | LILACS | ID: biblio-1385616

ABSTRACT

RESUMEN: El pudú (Pudu puda), pertenece al orden Artiodactyla y a la familia Cervidae, corresponde al segundo cérvido más pequeño del mundo y es endémico de Chile y Argentina. Son herbívoros que se alimentan de hojas jóvenes y brotes de algunos árboles, arbustos, hierbas, frutos y flores. Esta especie está catalogada en estado Vulnerable, por lo que se prohíbe su caza y captura, esto debido a que su población ha disminuido sustancialmente a causa de la pérdida y fragmentación de la vegetación nativa, los incendios forestales, ataques de perros asilvestrados y caza furtiva. Existe escasa información científica anatómica de esta especie, y más aún referente a su morfología digestiva, por lo que se requieren estudios que aporten información específica de este cérvido. Se utilizaron dos cadáveres de pudú hembras adultas, los cuales fueron donados por el Servicio Agrícola y Ganadero (SAG) de Talca, Región del Maule, Chile. Dentro de los resultados, podemos indicar que la cavidad oral, glándulas salivares y esófago se asemejan a otros rumiantes domésticos, como también existen semejanzas con el venado de campo, sin embargo, existen diferencias como la forma y desarrollo de la glándula parótida; el conducto parotídeo pasa ventral al músculo masetero y se abre en una papila a nivel del tercer premolar superior; la glándula mandibular se divide en tres lobos; la glándula sublingual solo posee porción polistomática, las glándulas bucales dorsales poseen un menor tamaño que las bucales ventrales, la glándula bucal ventral es alargada y de forma compacta y se observa la presencia de una redondeada glándula bucal intermedia, poseen 11 crestas palatinas por lado en el paladar duro y además la papila incisiva se encuentra rodeando al pulvino dental. Esta información es relevante y corresponde a un aporte al conocimiento específico de esta especie, la cual es endémica, vulnerable y protegida.


SUMMARY: The pudu (Pudu puda), belongs to the Artiodactyla order and the Cervidae family, corresponding to the second smallest deer in the world and is endemic to Chile and Argentina. They are herbivores that feed on young leaves and shoots of certain trees, shrubs, herbs, fruits, and flowers. The status of is species is classified as Vulnerable; therefore, its hunting and capture is prohibited, this because its population has decreased substantially due to the loss and fragmentation of native vegetation, forest fires, attacks by feral dogs and poaching. There is little scientific anatomical information available on this species, and even more so regarding its digestive morphology, which is why studies are required to provide specific information on this deer. Two adult female pudu specimens were used, which were donated by the Agricultural and Livestock Service (SAG) of Talca, Maule Region, Chile. Among the results, we can indicate that the oral cavity, salivary glands and esophagus resemble other domestic ruminants; there are also similarities with the field deer, however, there are differences such as the shape and development of the parotid gland; the parotid duct passes ventral to the masseter muscle and opens into a papilla at the level of the upper third premolar; the mandibular gland is divided into three wolves; the sublingual gland only has a polystomatic portion, the dorsal buccal glands are smaller than the ventral buccal glands, the ventral buccal gland is elongated and compact and the presence of a rounded intermediate buccal gland is observed, it has 11 palatal ridges per side in the hard palate and also the incisive papilla is found surrounding the dental pulvino. This information is relevant and corresponds to a report on the specific knowledge of this species, which is endemic, vulnerable, and protected.


Subject(s)
Animals , Salivary Glands/anatomy & histology , Deer , Esophagus/anatomy & histology , Mouth/anatomy & histology
19.
Int. j. morphol ; 40(2): 355-359, 2022. ilus
Article in Spanish | LILACS | ID: biblio-1385623

ABSTRACT

RESUMEN: Tradicionalmente, la Histología se ha apoyado del análisis de preparaciones histológicas a través del microscopio para su enseñanza. En este sentido, uno de los principales obstáculos que enfrentan los estudiantes al analizar los tejidos, es extrapolar una imagen bidimensional a una estructura tridimensional (3D). La impresión 3D permite subsanar esta limitación, haciendo posible fabricar material docente, con las características requeridas con un alto grado de detalle y bajo costo. El objetivo de este trabajo fue diseñar y fabricar modelos impresos en 3D como complemento para las clases prácticas de Histología Médica. Se fabricaron modelos impresos en 3D de la ultraestructura de la barrera de filtración glomerular (BFG) en su estado normal y síndrome nefrótico. Además, se fabricó un modelo de la capa muscular del esófago humano dando énfasis a la disposición helicoidal de sus fibras musculares. Los modelos de epidermis permitieron identificar sus distintos estratos: estrato córneo, estrato granuloso, estrato espinoso, y estrato basal. Dentro los beneficios derivados de la impresión de modelos en 3D podemos destacar el bajo costo económico de su fabricación, alta reproducibilidad, bioseguridad, y potencial para favorecer el aprendizaje y la enseñanza de la Histología. No obstante, es necesario analizar la percepción y beneficio sobre el aprendizaje de los estudiantes derivados de la aplicación de los modelos mediante técnicas de evaluación cuantitativas y cualitativas.


SUMMARY: Traditionally, Histology has relied on the analysis of histological slides through the microscope for its teaching. In this sense, one of the main obstacles faced by students when analyzing tissues is to extrapolate a two-dimensional image to a three-dimensional (3D) structure. 3D printing makes it possible to overcome this limitation, making it possible to manufacture teaching material with the required characteristics with a high degree of detail and low cost. The objective of this work was to design and manufacture 3D printed models as a complement for the practical classes of Medical Histology. 3D printed models of the ultrastructure of the glomerular filtration barrier (GFB) in its normal state and nephrotic syndrome were fabricated. In addition, a model of the muscular layer of the human esophagus was fabricated emphasizing the helical arrangement of its muscle fibers. The epidermis models allowed the identification of its different layers: stratum corneum, stratum granulosum, stratum spinosum, and stratum basale. Among the benefits derived from 3D printing of models, we can highlight the low economic cost of manufacturing, biosafety and potential to favor the learning and teaching of Histology. However, it is necessary to analyze the perception and benefit on student learning derived from the application of the models by means of quantitative and qualitative evaluation techniques.


Subject(s)
Humans , Printing, Three-Dimensional , Histology/education , Models, Anatomic , Epidermis/anatomy & histology , Esophagus/anatomy & histology , Glomerular Filtration Rate
20.
J. vasc. bras ; 21: e20220012, 2022. graf
Article in Portuguese | LILACS | ID: biblio-1386126

ABSTRACT

Abstract Accidental fish bone ingestion is a common complaint at emergency departments. The majority of cases have a benign course. However, serious complications such as esophagus perforation, cervical vessel injury and cervical abscess can occur in 7.4% of cases. Mortality rates can be as high as 50% when mediastinitis occurs. We report a case of an esophageal perforation caused by a fish bone with a lesion to the right common carotid artery after 20 days of evolution. Surgical exploration occurred with corrections of the lesion in the right common carotid and esophagus. Early identification of this kind of injury is paramount to prevent potentially fatal complications.


Abstract Accidental fish bone ingestion is a common complaint at emergency departments. The majority of cases have a benign course. However, serious complications such as esophagus perforation, cervical vessel injury and cervical abscess can occur in 7.4% of cases. Mortality rates can be as high as 50% when mediastinitis occurs. We report a case of an esophageal perforation caused by a fish bone with a lesion to the right common carotid artery after 20 days of evolution. Surgical exploration occurred with corrections of the lesion in the right common carotid and esophagus. Early identification of this kind of injury is paramount to prevent potentially fatal complications.


Subject(s)
Humans , Female , Adult , Carotid Arteries/diagnostic imaging , Esophagus/diagnostic imaging , Foreign Bodies/diagnostic imaging , Carotid Arteries/surgery , Esophagus/surgery , Foreign Bodies/complications
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