ABSTRACT
Dysphagia associated with esophageal mechanical obstruction is usually related to malignant esophageal diseases. Benign lesions are rarely a cause for this type of dysphagia, and usually occur either as an intramural tumor or as an extrinsic compression. Mediastinal tuberculous lymphadenitis is rare in adults, and even more rarely causes dysphagia. We report two cases of dysphagia in adult patients caused by mediastinal tuberculous lymphadenitis, presenting radiologically and endoscopically as an esophageal submucosal tumor. Based on the clinical and imaging diagnosis, the patients underwent a right thoracotomy, and excision of the mass attached to and compressing the esophagus. Pathological examination of the specimens showed a chronic granulomatous inflammation with caseous necrosis, which was consistent with tuberculous lymphadenitis.
Subject(s)
Deglutition Disorders/etiology , Mediastinal Diseases/diagnosis , Tuberculosis, Lymph Node/diagnosis , Adult , Diagnosis, Differential , Esophageal Neoplasms/diagnosis , Female , Humans , Mediastinal Diseases/complications , Middle Aged , Tuberculosis, Lymph Node/complicationsABSTRACT
In digestive circular mechanical anastomosis, a purse-string suture is normally performed in order to ensure that the anvil is securely fixed in place. We present a new technique where an adjustable plastic belt is used instead of the purse-string suture for the same effect. The procedure has been used on 10 patients with esophageal and gastric carcinomas. There was no difficulty in performing the anastomosis in any of the cases. We believe the procedure is technically simple and safe, and provides a significant advance in automatic digestive suturing.
