ABSTRACT
In a series of 127 consecutive patients operated on for thoracic outlet syndrome and 100 consecutive patients who had antireflux operations for reflux esophagitis, we found a high incidence of association between thoracic outlet syndrome, reflux esophagitis, and cardiovascular disease. In the group of patients with thoracic outlet syndrome, 35.4% had reflux esophagitis and 26%, cardiovascular disease. Of the patients operated on for reflux esophagitis, 38% were found to also have thoracic outlet syndrome and 39%, cardiovascular disease. While cardiovascular diseases have by far the most serious consequences for patients with chest pain, the high incidence of association between cardiovascular diseases, reflux esophagitis, and thoracic outlet syndrome comprises a triad helpful for the etiologic diagnosis of chest pain.
Subject(s)
Cardiovascular Diseases/complications , Esophagitis, Peptic/complications , Nerve Compression Syndromes/complications , Pain/etiology , Thorax , Adolescent , Adult , Aged , Cardiovascular Diseases/diagnosis , Esophagitis, Peptic/diagnosis , Female , Humans , Male , Middle Aged , Neck , Spinal Nerve Roots , SyndromeABSTRACT
The high incidence of respiratory symptoms in patients with reflux esophagitis reported in the literature supports a cause-effect relationship between esophageal reflux and pulmonary symptoms. Analysis of the results of routine preoperative pulmonary function tests on 90 patients with reflux esophagitis and on 277 patients having nonthoracic elective surgery revealed that although the incidence of obstructive lung disease was high in both groups, it was higher in the general surgical population (51.9%) than in the patients with reflux esophagitis (37.7%). Thus a cause-and-effect relationship cannot be established between reflux esophagitis and obstructive lung impairment. This study indicates that the incidence of significant obstructive lung impairment in the general surgical population is greatly underestimated.
Subject(s)
Hernia, Diaphragmatic/complications , Hernia, Hiatal/complications , Respiratory Tract Diseases/complications , Adolescent , Adult , Aged , Esophagitis, Peptic/complications , Forced Expiratory Flow Rates , Forced Expiratory Volume , Hernia, Hiatal/physiopathology , Humans , Middle Aged , Respiratory Function Tests , Respiratory Tract Diseases/diagnosis , Smoking , Vital CapacityABSTRACT
The purpose of this study was to determine the incidence of obstructive lung disease in a surgical population. Screening spirometric pulmonary function tests were performed in 300 consecutive ambulatory patients in a community hospital. A high incidence of moderate to very severe chronic obstructive lung disease was found, 66% of smokers and 38% of nonsmokers. The incidence of chronic obstructive lung disease is underestimated. The costs of this disease are staggering in terms of money and manpower, and there is great need for screening pulmonary function testing to promote early diagnosis. The community hospital appears to be the ideal environment in which to make an early diagnosis and initiate measures to attempt to change the natural history of chronic obstructive lung disease.
