Congenital tracheal stenosis complicated with communicating bronchopulmonary foregut malformation in 2 children and literature review / 中华实用儿科临床杂志

Objective:To explore the clinical typing, diagnostic method and treatment plan of congenital tracheal stenosis (CTS) combined with communicating bronchopulmonary foregut malformation (CBPFM) in children.Methods:The clinical data of 2 children with CTS and CBPFM who were treated in the Center for Respiratory Intervention of Children′s Hospital Affiliated to Shandong University in May 2021 and January 2022 were retrospectively analyzed.Studies were retrieved from domestic and foreign databases, so as to summarize the clinical characteristics of CTS complicated with CBPFM and investigate the typing method of CBPFM.Results:One patient was a 4-year-old girl, who sought the medical advice due to " recurrent cough and asthma for more than 4 years" . She was diagnosed with typeⅡ CBPFM at the right side and CTS.Surgical thoracoscopic right pneumonectomy plus oesophageal repair was performed.The other patient was a 7-month-and-2-day-old female, who visited the hospital for " difficult eating, dyspnea and purple lip cyanosis for 7 months" . This patient was diagnosed with typeⅡ CBPFM at the left side and CTS.Slide tracheoplasty and left pneumonectomy+ oesophageal repair were performed successively.Eight English and one Chinese studies were collected.Twenty-one children with CBPFM and 12 children with CTS and CBPFM were included.Eleven CTS cases with sufficient diagnostic evidence were complicated with typeⅠA and typeⅡCBPFM.Conclusions:CTS and CBPFM can lead to severe wheezing and dyspnea.Clinicians should enhance their awareness and be more cautious.There may be a potential link between CTS and typeⅠA and typeⅡCBPFM, and further investigation is required.

Bronchogenic cyst presenting as content of omphalocele – A case report

Bronchogenic cyst (BC) is a very rare congenital anomaly occurring due to budding of the primitive foregut, and its common location is the posterior mediastinum. BC when diagnosed prenatally can be treated if it is encroaching on the development of lungs. BC has been reported in other locations such as cervical, thoracic, abdominal sites and also as subcutaneous lesions. Omphalocele is a congenital malformation occurring due to a central defect in the abdominal wall with herniation of the viscera. The nonentity documented here was found in a female fetus with 20 weeks of gestational age. The mother was a primigravida who had antenatal ultrasound scan rendering diagnosis of a live fetus having abdominal wall defect with omphalocele. This case is exceptionally rare as the content of omphalocele was BC having a classical wall lined by pseudostratified ciliated columnar epithelium overlying band-like cartilage. The extensive search in the literature did not reveal another similar case.

Structure of the mouthparts and alimentary canal of Eusomus ovulum Germar, 1824 (Coleoptera: Curculionidae)

ABSTRACT The structural morphology of mouthparts, the distribution of sensilla on the mouthparts, histology, and the morphology of the alimentary canal in adult Eusomus ovulum Germar, 1824 were examined under both light and scanning electron microscopy (SEM). The mouthparts are located at the tip of the short rostrum. The mandibles, the maxillae and the labial palpi comprise the moveable mouthparts. Also there are sensillae which act as chemoreceptors on the terminal segment of the snout. Alimentary canal of adult E. ovulum is divided into three main regions, foregut, midgut and hindgut. The first part of the gut is foregut, which is made up of a pharynx, esophagus, crop and proventriculus. The pharynx extends from the mouth, having muscle attachments radiating out from its surface and connecting with the head region. The esophagus is a narrow epithelial tube contiguous and posterior to the pharynx. The proventriculus consists of 8 sclerotized plates. The midgut, which is anteriorly bulbous with a tubular posterior half. Gastric caeca were found on the posterior region of the midgut. The midgut is surrounded by outer muscles and inner columnar epithelium. The hindgut has pylorus, ileum, colon, and rectum. There are three histological layers of the hindgut from lumen to hemocoel: intima, epithelium, muscles. The hindgut has a cryptonephridial attachment for the six Malpighian tubes anterior to the rectum. The aim of the present study is to contribute information on the morphology of mouthparts, and the morphology and histology of the alimentary tract of the insect.

Evolución de operaciones por enfermedades del intestino proximal y glándulas anexas realizadas en Chile entre 2011 y 2016 / Evolution of surgeries due to diseases of the proximal intestine and anexal glands perfomed in Chile between 2011 and 2016

INTRODUCCIÓN: Los datos sobre número de operaciones realizadas en Chile en patología del intestino proximal y glándulas anexas, han sido cada vez más precisas en los registros estadísticos del MINSAL en los últimos años. OBJETIVO: a) Incorporar datos de otras operaciones no incluidas en reportes previos, b) comparar los resultados de operaciones de alta complejidad reportadas el año 2011 y confrontarlos con los datos del año 2016. MATERIAL Y MÉTODO: En el DEIS (Departamento de Estadística e Información de Salud) se obtuvo el número total de operaciones realizadas en Chile el año 2016 y mortalidad operatoria al momento del egreso de diferentes patologías del intestino proximal y glándulas anexas, siendo la mayoría tumores malignos: cáncer de esófago, estómago, páncreas, hígado y vías biliares intrahepáticas y vesícula biliar. Los resultados se compararon con los obtenidos del año 2011. RESULTADOS: La letalidad anual de cánceres digestivos demostró un alza del cáncer de páncreas e hígado, mientras que se aprecia una baja en el cáncer de esófago y vesícula biliar. Operaciones de patología benigna, como la esofagocardiomiotomía y cirugías antirreflujo laparoscópica no mostraron mortalidad, al igual que el bypass gástrico. La colecistectomía y la gastrectomía vertical laparoscópicas, tuvieron una muy baja mortalidad operatoria. En las intervenciones quirúrgicas por tumores malignos se apreció en todos una disminución de la mortalidad operatoria comparado con el año 2011, aunque no fue estadísticamente significativo. CONCLUSIÓN: El presente estudio muestra un aumento de las operaciones por enfermedades del intestino proximal y glándulas anexas así como una disminución de la mortalidad operatoria el año 2016 comparado con el 2011.

INTRODUCTION: The number of operations performed in Chile due to diseases for the foregut, have been every time more precise and complete in the National Register Data of Statistics in Health (MINSAL), and published in several reports (years 1983, 2005 and 2011). OBJECTIVES: a) to incorporate data of new operations not included before and b) to compare the results of high complex operations reported on 2011 and 2016. MATERIAL AND METHODS: from the DEIS (Department of Statistics and Information of Health) we obtained the total number of operations performed during 2016, and the operative mortality at the time of discharge from the hospital for different diseases of the foregut been the majority malignant tumors: esophageal cancer, gastric cancer, pancreatic cancer, liver and bile ducts carcinoma, and cancer of the gallbladder. The results were compared to dose obtained the year 2011. RESULTS: The annual lethality of digestive malignant tumors showed an increase in pancreatic and liver cancer, while a decrease was observed in patients with esophageal cancer al gallbladder cancer. Operations for benign pathology like esophagomiotomy and laparoscopic antireflux surgery showed no mortality, as well as gastric bypass. Laparoscopic cholecistectomy, and laparoscopic sleeve gastrectomy presented a very low mortality. Surgical procedures for malignant diseases showed a decrease in operative mortality compare to 2011, although not significant. CONCLUSIONS: The present study shows an increase in the operations for foregut diseases performed during 2016 compared with the year 2011, as well as a decrease in operative mortality.

A Case of Ciliated Foregut Cyst of the Gallbladder / 대한소화기학회지

Congenital cysts of the gallbladder are extremely rare, hence only a few ciliated foregut cysts of gallbladder have been reported. We report a case of a 20-year-old woman presenting with mild right upper quadrant abdominal discomfort, with normal levels of serum bilirubin and liver function tests. Abdominal ultrasonography revealed a well-defined cystic mass measured about 2 cm attached to the neck of gallbladder, with internal echogenic debris suggesting a complicated cyst, such as a hemorrhagic cyst. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed similar findings. Laparoscopic cholecystectomy showed a slightly distended gallbladder. The size of cyst on the neck was 1.6x1.2 cm, and it contained mucosa lined by ciliated pseudostratified columnar epithelium and underlying smooth muscle layers. Histopathology identified a ciliated foregut cyst of gallbladder.

Ciliated foregut cyst of the gallbladder: a case report and literature review

Ciliated foregut cyst of gallbladder is a very rare benign cystic lesion. A 39-year-old woman was referred to our hospital after abdominal ultrasonography revealed a cystic lesion of gallbladder. On abdominal ultrasonography and computed tomography, a unilocular cystic lesion was found at right upper quadrant with attachment to the gallbladder neck. The gallbladder with cystic lesion was resected through laparoscopic cholecystectomy. The cystic lesion revealed a unilocular cyst with ciliated cuboidal or columnar epithelium and abundant goblet cells. Pathologic examination is essential to distinguish from other cystic lesions of the gallbladder and avoid unnecessary additional treatment. In the current case report, we presented the clinico-pathologic findings of the ciliated foregut cyst of the gallbladder and review of literature.

Cisto hepático ciliado: relato de um caso / Ciliated hepatic foregut cyst: a case report

Os cistos hepáticos ciliados são estruturas originadas do desenvolvimento embrionário anormal. Eles são raros e benignos, mas que necessitam de tratamento quando sintomáticos ou ao sofrerem malignização. Descrevemos um caso de uma paciente de 32 anos diagnosticada e tratada por videolaparoscopia após apresentar dor abdominal em epigástrio e hipocôndrio direito, náusea e disfagia.

Ciliated hepatic foregut cysts are structures from abnormal embryonic development. They are rare and benign, but need treatment when symptoms or undergo malignant transformation. We described a case report of a 32-years woman diagnosed and surgically treated after abdominal pain in the epigastrium and right hypochondrium, nausea and dysphagia.

Clinico-Anatomical Study of Variations In Arterial Supply of Adult Human Stomach.

Anatomical variations in the arterial supply of adult human stomach have long baffled even themost experienced surgeons during surgical manipulation of the stomach. The stomach develops from the foregut hence its arterial supply is derived from the coeliac trunk. The present study is aimed at observing the anatomical variations of the arteries supplying the stomach. This study has been conducted on fifty cadavers during routine dissections. The aberrant arteries observed have both embryological and clinical significance. A comprehensive knowledge of the arteries nourishing the stomach along with their anomalies is vital for the surgeons to avoid iatrogenic complications during surgical manipulation involving the organ.

Oral foregut cyst in the ventral tongue: a case report

An oral foregut cyst is a rare congenital choristoma lined by the respiratory and/or gastrointestinal epithelium. The exact etiology has not been fully identified, but it is thought to arise from misplaced primitive foregut. This lesion develops asymptomatically but sometimes causes difficulty in swallowing and pronunciation depending on its size. Thus, the first choice of treatment is surgical excision. Surgeons associated with head and neck pathology should include the oral foregut cyst in the differential diagnosis for ranula, dermoid cyst, thyroglossal duct cyst and lymphangioma in cases of pediatric head and neck lesions.

Ciliated hepatic foregut cyst / 대한간학회지

No abstract available.

A Case of Ciliated Hepatic Foregut Cyst Discovered by Chance in Elderly Patient with Cholecystitis and Cholangitis

Ciliated hepatic foregut cyst (CHFC) is a rare disease that originates from the tracheobronchial tree of the foregut. Most patients with CHFC, which is believed to be a non-malignant neoplasm, are clinically asymptomatic. However, there have been some case reports that identify it as changing to malignant in the last decade of the condition. Surgical excision is, therefore, preferred to observation as the treatment of CHFC. However, surgical excision of CHFC in asymptomatic elderly patients is controversial. We experienced a rare case of a 73-year-old female patient who was accidentally diagnosed with CHFC while being diagnosed for cholecystitis and cholangitis. The patient simultaneously underwent laparoscopic cholecystectomy and resection of CHFC, which was finally diagnosed as benign. We report asymptomatic CHFC in elderly patient, focusing our discussion on whether surgical excision of CHFC is necessary for asymptomatic elderly patients. According to a review of case reports, surgical excision of CHFC is not necessary for asymptomatic elderly patients.

Bronchopulmonary foregut malformation mimicking pseudocyst of pancreas.

We report a four-yr-old girl who was successfully treated for a large gastro-duodenal duplication that communicated with extra-lobar pulmonary sequestration on one end and the main pancreatic duct on the other. Such an association has not been reported hitherto.

Foregut cystic developmental malformation: New taxonomy and classification - Unifying embryopathological concepts.

Foregut cystic developmental malformations are rare developmental anomalies. The problems inherent to these malformations are their presentation across specialties that include embryology, anatomy, pathology, thoracic foregut surgery, pediatric surgery and general abdominal surgery. The direct consequence of this variation has resulted in diverse terminology, classification and a failure to identify the correlation. The article aims to summarize and unify the embryological concepts of foregut cystic malformation, to suggest a generic title to the various groups of these interrelated disorders and a uniform use of nomenclature on the basis of unifying concepts of embryopathogeneis.

Development and functional morphology of the foreguts of larvae and postlarvae of three crustacean decapods

The development of the foregut structure and the digestive function of the decapods Litopenaeus vannamei, Sesarma rectum and Callichirus major larvae and post larvae were examined. The protozoeal foregut of L. vannamei is simple, lacking a cardiopyloric valve and bearing a rudimentary filter press. In mysis, the filter press is more developed. In the juvenile stage, grooves and a small lateral tooth arise. In S. rectum, the foregut has a functional cardiopyloric valve and a filter press. The megalopal and juvenile stages of this species have a gastric mill similar to those in adult crabs. In C. major, the foregut of the zoeae is specialized, with the appearance of some rigid structures, but no gastric mill was found. Calcified structures are observed in the megalopae and they become more developed in the juvenile stage. The results support suppositions, previously reported in other studies, that feeding behavior of each larval and postlarval stage is directly related to the morphological characteristics of the foreguts.

O desenvolvimento da estrutura do estômago e da função digestiva foi examinada em larvas e pós-larvas de Litopenaeus vannamei, Sesarma rectum e Callichirus major. O estômago do protozoea de L. vannamei é muito simples, sem válvula cárdiopilórica e apresenta um filtro pilórico rudimentar. Em mysis, o filtro pilórico parece ser mais desenvolvido. No juvenil I surgem calhas e dentes laterais pouco desenvolvidos. Os estômagos dos zoeae de S. rectum possuem a válvula cárdiopilórica e o filtro pilórico funcionais. Nos estágios megalopa e juvenil I o moinho gástrico é complexo. Em C. major, os estômagos dos zoeae se mostram especializados exibindo algumas estruturas rígidas, mas não apresentam moinho gástrico. Esta estrutura surge no megalopa e juvenil I. Os resultados suportam suposições anteriores que o comportamento alimentar de larvas e pós-larvas está diretamente relacionado com as características morfológicas dos estômagos.

A Systematic Classification of the Congenital Bronchopulmonary Vascular Malformations: Dysmorphogeneses of the Primitive Foregut System and the Primitive Aortic Arch System

PURPOSE: We reviewed the cases of 33 patients from our clinic and 142 patients from the literature with congenital bronchopulmonary vascular malformations (BPVM), systematically analyzed the bronchopulmonary airways, pulmonary arterial supplies, and pulmonary venous drainages, and classified these patients by pulmonary malinosculation (PM). MATERIALS AND METHODS: From January 1990 to January 2007, a total of 33 patients (17 men or boys and 16 women or girls), aged 1 day to 24 years (median, 2.5 months), with congenital BPVM were included in this study. Profiles of clinical manifestations, chest radiographs, echocardiographs, esophagographs, computer tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), cardiac catheterizations with angiography, contrast bronchographs, bronchoscopies, chromosomal studies, surgeries, and autopsies of these patients were analyzed to confirm the diagnosis of congenital BPVM. A total of 142 cases from the literature were also reviewed and classified similarly. RESULTS: The malformations of our 33 patients can be classified as type A isolated bronchial PM in 13 patients, type B isolated arterial PM in three, type C isolated venous PM in two, type D mixed bronchoarterial PM in five, type F mixed arteriovenous PM in one, and type G mixed bronchoarteriovenous PM in nine. CONCLUSION: Dysmorphogeneses of the primitive foregut system and the primitive aortic arch system may lead to haphazard malinosculations of the airways, arteries, and veins of the lung. A systematic classification of patients with congenital BPVM is clinically feasible by assessing the three basic bronchovascular systems of the lung independently.

Congenital Bronchopulmonary Foregut Malformation: Analysis of the surgical and autopsy cases

Because early embryonic development of the tracheobronchial tree and foregut are closely associated, there is a wide spectrum of congenital anomalies involving either one or both organ systems. We analysed a total of 89 surgical and autopsy cases that are assumed to belong to congenital bronchopulmonary foregut malformation from the files of Seoul National University Hospital and Children's Hospital during the periord of 1961~1990. We also reviewed the serial sections of the embryos and fetuses from 3 weeks to fifteen weeks fertilization age for the observation of tracheobronchial and esophageal trees. Intralobar sequestrations(25 cases) and extralobar pulmonary sequestrations(4 cases) with patent, involuted-partial or complete-communication with the alimentary tract, tracheoesophageal fistula(30 cases) with or without esophageal atresia, esophageal atresia, esophageal stenosis due to tracheobroncheal remnant(4 cases), foregut duplication cysts(3 cases), esophageal or gastric diverticulum(1 cases), and bronchogenic cysts(22 cases) are included in this analysis(Table 1). Through this study, we confirmed the unifying concept of "bronchopulmonary forgut malformations". We believe a common embryologic pathogenesis leads to the formation of a previously described spectrum of malformations.

Spinal Neurenteric Cyst of Foregut Origin

The neurenteric cyst with associated anomalies is the result of an ectoentodermal communication that exists during embryogenesis. The variety of lesions include intraspinal cysts, congenital vertebral deformities, thoracic cyst, malformations of the digestive tract, and occasionally, dysrhaphias of the sinodermal or myelomeningocele type. A case of intraspinal neurenteric cyst in a 3-year-old boy is presented. He presented with cyclic abdominal pain, fever and constipation of 30 days' duration. These symptoms progressed rapidly into gait disturbance and left hemiplegia. A single epithelial cyst, located ventral to the spinal cord in the lower thoracic region, traversed the cleft of spina bifida of thoracic vertebrae and connected to retromediastinal cyst. The inner cyst wall was lined with pseudostratified ciliated epithelia and a few squamous cells. The cyst wall contained well-developed muscle coat, myenteric plexuses, and scattered seromucinous glands.

Ciliated Foregut Cyst of the Liver: Report of a case

We report a case of ciliated hepatic foregut cyst which was incidentally found in a 64 year-old man. The cyst, 6 cm in diameter, was unilocular, solitary and was located in the medial segment of left lobe, just below the Glisson's capsule. Microscopically, the cyst wall consisted of 4 layers; pseudostratified ciliated columnar epithelium, subepithelial loose connective tissue, smooth muscle bundles and an outermost fibrous capsule. Although cartilage or subepithelial sero-mucous glands were absent, the morphologic features of the cyst correspond with those of an incomplete form of brochogenic cyst.