RESUMEN
BACKGROUND: Oesophageal disorders and chronic liver disease are common worldwide and significantly impact quality of life. The intricate link between these conditions, including how oesophageal disorders like GERD, Barrett's oesophagus and oesophageal cancer affect and are affected by chronic liver disease, remains poorly understood. AIMS: To review the relationship between oesophageal disorders and chronic liver disease, evaluating epidemiology, pathophysiology and therapeutic factors. METHODS: We reviewed the literature on the relationship between oesophageal disorders and chronic liver disease, including cirrhosis, using the PubMed database RESULTS: Oesophageal disorders such as gastroesophageal reflux disease, Barrett's oesophagus, oesophageal cancer, oesophageal motor disorders and oesophageal candidiasis are prevalent among individuals with cirrhosis, exacerbating the burden of liver disease. These diseases have a multifaceted symptomatology and pathogenic basis, posing a significant challenge in cirrhotic patients that necessitates careful diagnosis and management. Additionally, therapies frequently used for these diseases, such as proton pump inhibitors, require careful consideration in cirrhotic patients due to potential adverse effects and altered pharmacokinetics. Managing oesophageal disorders in cirrhotic patients requires a cautious approach due to possible interactions with medications and the risk of adverse effects. Furthermore, symptoms associated with these conditions are often exacerbated by common interventions in patients with cirrhosis, such as band ligation for oesophageal varices. CONCLUSIONS: Oesophageal disorders are common in cirrhosis and increase the disease burden. These conditions require careful management due to complex symptoms and treatment risks. Proton pump inhibitors and other therapies must be used cautiously, as cirrhosis interventions can worsen symptoms.
Asunto(s)
Enfermedades del Esófago , Hepatopatías , Humanos , Enfermedades del Esófago/fisiopatología , Enfermedades del Esófago/etiología , Enfermedades del Esófago/complicaciones , Hepatopatías/complicaciones , Hepatopatías/fisiopatología , Enfermedad Crónica , Cirrosis Hepática/complicaciones , Cirrosis Hepática/fisiopatología , Calidad de Vida , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/fisiopatología , Inhibidores de la Bomba de Protones/uso terapéuticoRESUMEN
INTRODUCTION: Button battery (BB) ingestion injuries are a devastating and preventable event within the pediatric population. Efforts to reduce the prevalence of esophageal button battery ingestion injuries include primary preventative measures. It is integral to assess the public's baseline knowledge about BB injuries to tailor future primary prevention efforts. METHODS: This is a crowdsourcing survey-based study. Participants were notified through our institution's Twitter and Instagram accounts. RESULTS: There were 930 completed survey responses from May to June 2022. The survey found that 87% (791/910) knew that swallowing a BB could cause injury and 71% knew that it could cause death (642/905). Eight-five percent of respondents did not know what signs and symptoms to look for after BB ingestion, only 30% (99/340) of healthcare professionals felt they would know. Only 10.1% (94/930) of participants knew to give children over 12 months old honey after suspected BB ingestion. Thirty-four percent (311/930) knew that complications could still occur even after BB were removed. Seventy-seven percent (719/930) knew that a dead BB could cause injury but only 17% knew the correct way to dispose of a dead button battery (158/930). Only 8% (72/930) of participants were knew that wrapping dead BB in tape could potentially prevent injury. CONCLUSION: The current study reveals gaps in the public's understanding of BB injury including: the presentation of BB injuries; the delayed harm of BB impactions; management and mitigation strategies, and BB disposal methods. This survey provided imperative insights to help guide future education and primary prevention initiatives.
Asunto(s)
Enfermedades del Esófago , Cuerpos Extraños , Medios de Comunicación Sociales , Niño , Humanos , Lactante , Estudios Transversales , Cuerpos Extraños/epidemiología , Cuerpos Extraños/etiología , Cuerpos Extraños/prevención & control , Enfermedades del Esófago/complicaciones , Suministros de Energía Eléctrica , Ingestión de AlimentosRESUMEN
Hiatus hernia (HH) is a prevalent endoscopic finding in clinical practice, frequently co-occurring with esophageal disorders, yet the prevalence and degree of association remain uncertain. We aim to investigate HH's frequency and its suspected association with esophageal disorders. We reviewed endoscopic reports of over 75,000 consecutive patients who underwent gastroscopy over 12 years in two referral centers. HH was endoscopically diagnosed. We derived data on clinical presentation and a comprehensive assessment of benign and malignant esophageal pathologies. We performed multiple regression models to identify esophageal sequela associated with HH. The overall frequency of HH was (16.8%); the majority (89.5%) had small HHs (<3 cm). Female predominance was documented in HH patients, who were significantly older than controls (61.1±16.5 vs. 52.7±20.0; P < 0.001). The outcome analysis of esophageal pathology revealed an independent association between HH, regardless of its size, and erosive reflux esophagitis (25.7% vs. 6.2%; OR = 3.8; P < 0.001) and Barrett's esophagus (3.8% vs. 0.7%; OR = 4.7, P < 0.001). Furthermore, following rigorous age and sex matching, in conjunction with additional multivariable analyses, large HHs were associated with higher rates of benign esophageal strictures (3.6% vs. 0.3%; P < 0.001), Mallory Weiss syndrome (3.6% vs. 2.1%; P = 0.01), and incidents of food impactions (0.9% vs. 0.2%; P = 0.014). In contrast, a lower rate of achalasia was noted among this cohort (0.55% vs. 0%; P = 0.046). Besides reflux-related esophageal disorders, we outlined an association with multiple benign esophageal disorders, particularly in patients with large HHs.
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Hernia Hiatal , Humanos , Hernia Hiatal/complicaciones , Hernia Hiatal/epidemiología , Femenino , Masculino , Persona de Mediana Edad , Anciano , Macrodatos , Adulto , Prevalencia , Enfermedades del Esófago/epidemiología , Enfermedades del Esófago/complicaciones , Enfermedades del Esófago/etiología , Esófago de Barrett/complicaciones , Esófago de Barrett/epidemiología , Gastroscopía/estadística & datos numéricos , Estudios Retrospectivos , Esofagitis Péptica/epidemiología , Esofagitis Péptica/complicaciones , Esofagitis Péptica/diagnóstico , Análisis de DatosRESUMEN
Acute esophageal necrosis (AEN) or black esophagus is a rare cause of mortality in patients with gastrointestinal bleeding. We present a case of a 54-year-old female who presented with diabetic ketoacidosis (DKA) and developed melena eventually attributed to AEN. The esophagogastroduodenoscopy (EGD) identified severe inflammation with black discoloration consistent with acute esophageal necrosis in the middle and lower esophagus. The patient was managed with intravenous pantoprazole and total parenteral nutrition (TPN) until she was able to tolerate an adequate diet. Black esophagus should be added to the differential diagnosis of patients with DKA who develop gastrointestinal bleeding. This need is stressed by the fact that early treatment is essential to reducing complications and mortality associated with the condition.
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Diabetes Mellitus , Cetoacidosis Diabética , Enfermedades del Esófago , Femenino , Humanos , Persona de Mediana Edad , Cetoacidosis Diabética/complicaciones , Cetoacidosis Diabética/diagnóstico , Enfermedad Aguda , Necrosis/complicaciones , Enfermedades del Esófago/etiología , Enfermedades del Esófago/complicaciones , Hemorragia Gastrointestinal/etiologíaRESUMEN
RATIONALE: Foreign body (FB) ingestion is a common clinical emergency, although in most cases, the FB can pass safely through the entire gastrointestinal tract without causing any damage. However, ingestion of large dentures is very rare and alarming, as it can threaten the intestinal mucosa and cause perforation of the gastrointestinal tract, among other complications. PATIENT CONCERNS: A 64-year-old Chinese male was referred to our hospital for removal of a FB, which was a large denture. Clinical symptoms included chest and upper abdominal pain. He had no cough or dyspnea. Medical history included a recent cerebral infarction, craniocerebral surgery, and being bedridden for a long term. DIAGNOSES: We initially suspected a single and smooth denture, complicated by pharyngeal and esophageal mucosal injury. Radiographic examination however showed a 70-mm long opaque object located in the middle and upper esophagus, close to the trachea and aorta. INTERVENTIONS: Multiple dentures and metal hooks were removed via endoscopy using a net, grasping forceps, and rubber jacket. OUTCOMES: The patient recovered well and experienced no postoperative complications. The patient was discharged 5 days after endoscopic therapy. LESSONS: Our case showed that endoscopy was effective for the retrieval of an esophageal FB. For sharp FBs, the use of a net and rubber jacket is a good choice. However, we advocate for appropriate surgery in patients in whom endoscopy is not possible after an accurate diagnosis or those with severe complications.
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Enfermedades del Esófago , Cuerpos Extraños , Masculino , Humanos , Adulto , Persona de Mediana Edad , Goma , Endoscopía Gastrointestinal , Enfermedades del Esófago/complicaciones , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Cuerpos Extraños/complicaciones , Ingestión de Alimentos , Dentaduras/efectos adversosRESUMEN
The Heimlich maneuver (HM) is lifesaving in a patient choked by a foreign body. It is safe and effective and does not require specific instruments. Nevertheless, rare severe complications have been reported, such as traumatic injury of the gastrointestinal tract, pneumomediastinum, rib fracture, diaphragm rupture, acute thrombosis of abdominal aortic aneurysm and mesenteric laceration. Abdominal injuries are the most common complications, especially esophageal and gastric wall rupture. This anatomic site is the most common location of organ injuries, in consequence of the main target of the force generated by the HM. Furthermore, the execution of HM by an untrained person may increase the risk for possible serious complications. Usually, HM complications are treated surgically, but based on clinical conditions, a conservative approach is possible. In our report, we described a case of esophageal rupture after a forceful HM, and we made a brief revision of literature concerning HM complications. We have also assessed the correlation between HM complications, abuse of non-steroidal anti-inflammatory drugs and the execution of the abdominal thrusts by untrained rescuers.
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Obstrucción de las Vías Aéreas , Aneurisma de la Aorta Abdominal , Enfermedades del Esófago , Maniobra de Heimlich , Rotura Gástrica , Traumatismos Torácicos , Humanos , Maniobra de Heimlich/efectos adversos , Aneurisma de la Aorta Abdominal/complicaciones , Obstrucción de las Vías Aéreas/complicaciones , Obstrucción de las Vías Aéreas/terapia , Traumatismos Torácicos/etiología , Rotura Gástrica/complicaciones , Enfermedades del Esófago/complicacionesRESUMEN
With the development of endoscopic technology, an increasing number of patients with esophageal disease are being diagnosed, although the underlying pathogenesis of many esophageal diseases remains unclear. In recent years, a large number of studies have demonstrated that the occurrence and development of various intestinal diseases were related to intestinal flora. As a result, researchers have shifted their focus towards investigating esophageal flora to better understand the pathogenesis, early diagnosis, and treatment of esophageal diseases. This paper reviewed the normal esophageal flora and the changes of esophageal flora under different esophageal disease states. It was observed that there are distinct differences in the composition of esophageal microflora among Gastroesophageal Reflux, Barrett's esophagus, eosinophilic esophagitis and normal esophagus. The normal esophageal flora was dominated by gram-positive bacteria, particularly Streptococcus, while the esophageal flora under esophagitis was dominated by gram-negative bacteria. Furthermore, the diversity of esophageal flora is significantly decreased in patients with esophageal cancer. Several potential microbial biomarkers for esophageal cancer have been identified, among which Fusobacterium nucleatum showed a close association with esophageal squamous cell carcinoma's pathological stage and clinical stage.
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Esófago de Barrett , Enfermedades del Esófago , Neoplasias Esofágicas , Carcinoma de Células Escamosas de Esófago , Humanos , Neoplasias Esofágicas/patología , Esófago de Barrett/complicaciones , Esófago de Barrett/epidemiología , Esófago de Barrett/patología , Enfermedades del Esófago/complicacionesRESUMEN
Pneumomediastinum is an uncommon finding in patients with diabetic ketoacidosis (DKA) and may occur spontaneously or secondary to an effort rupture of the oesophagus. Excluding oesophageal rupture is important, as delaying treatment increases the risk of mortality. We discuss a case of DKA complicated by vomiting, pneumomediastinum, pneumopericardium and air in the epidural space. Instead of fluoroscopic oesophagography, chest CT was used to investigate oesophageal rupture. We present an overview of case reports and retrospective studies illustrating the utility of chest CT in the investigation of oesophageal rupture over fluoroscopic oesophagography.
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Diabetes Mellitus , Cetoacidosis Diabética , Enfermedades del Esófago , Enfisema Mediastínico , Traumatismos Torácicos , Humanos , Enfisema Mediastínico/etiología , Enfisema Mediastínico/complicaciones , Cetoacidosis Diabética/complicaciones , Cetoacidosis Diabética/terapia , Estudios Retrospectivos , Tórax , Tomografía Computarizada por Rayos X/efectos adversos , Enfermedades del Esófago/complicaciones , Traumatismos Torácicos/complicacionesAsunto(s)
Trastornos de Deglución , Enfermedades del Esófago , Humanos , Trastornos de Deglución/diagnóstico por imagen , Trastornos de Deglución/etiología , Enfermedades del Esófago/complicaciones , Enfermedades del Esófago/diagnóstico por imagen , Dolor en el Pecho/etiología , Hematoma/diagnóstico por imagen , Hematoma/etiologíaRESUMEN
A 76-y-old Japanese man who had undergone gastrectomy 4.5 y earlier experienced 2 wk of sore throat, heartburn, and difficulty swallowing. Endoscopy showed deep, craterlike, longitudinal ulcers in the lower and middle esophagus. Immunohistochemistry and blood tests were negative for herpes simplex virus and cytomegalovirus infections. The patient reported no other symptoms affecting the gastrointestinal tract. Although his symptoms ameliorated after initial hospitalization and treatment, they re-emerged a few days after being discharged. Fifty-one days after being first admitted, he complained of glossalgia. The serum zinc level was found to be 38 µg/dL, which was below the reference range; the patient was diagnosed with zinc deficiency. After oral zinc administration, the patient was relieved of the symptoms, and his pain was alleviated. Upper gastrointestinal endoscopy after symptom relief showed improvement in the esophageal ulcers. He has continued taking zinc supplementations, and has not developed similar symptoms in the 5 y since being treated. To the best of our knowledge, this is the first case report of esophageal ulcers related to zinc deficiency.
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Enfermedades del Esófago , Desnutrición , Masculino , Humanos , Úlcera/tratamiento farmacológico , Úlcera/etiología , Enfermedades del Esófago/complicaciones , Gastrectomía/efectos adversos , Desnutrición/complicaciones , ZincAsunto(s)
Trastornos de Deglución , Enfermedades del Esófago , Mpox , Úlcera Péptica , Humanos , Mpox/complicaciones , Enfermedades del Esófago/inducido químicamente , Enfermedades del Esófago/diagnóstico , Enfermedades del Esófago/complicaciones , Trastornos de Deglución/complicaciones , Úlcera Péptica/complicacionesRESUMEN
A 76-year-old man with multiple cardiovascular risk factors (hypertension, DM2, LD, smoker) and severe peripheral arterial disease (iliofemoral bypass, supracondylar amputation) came to the emergency with coffee ground emesis and mild anemia. Urgent gastroscopy showed diffuse circumferential black mucosa covered by fibrin affecting the middle and distal esophageal third. Acute esophageal necrosis is a rare cause of gastrointestinal bleeding that should be suspected in patients with cardiovascular risk factors with an image of a black esophagus that is abruptly interrupted at the EGJ.
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Enfermedades del Esófago , Masculino , Humanos , Anciano , Necrosis/complicaciones , Enfermedades del Esófago/diagnóstico por imagen , Enfermedades del Esófago/cirugía , Enfermedades del Esófago/complicaciones , Hematemesis , Hemorragia Gastrointestinal/etiología , Enfermedad AgudaRESUMEN
Bipolar esophageal exclusion is a "Hail Mary" procedure for control of leak and persistent mediastinal soilage from esophageal injury. Usually, the esophageal remnant scars down without negative consequences. Esophageal mucocele is a rare complication of bipolar esophageal exclusion. This is a case report of an iatrogenic esophageal transection and the subsequent treatment course. A retrospective chart review of the patient's medical and surgical history was performed. After a robotic hiatal hernia repair at an outside institution, the patient suffered an esophageal leak and was surgically treated with esophageal exclusion, wide drainage of the mediastinum, and decortication of the resulting empyema. She subsequently underwent retrosternal gastric conduit for esophageal reconstruction 4 months later. Three years after this, she developed a rare complication of esophageal exclusion, a symptomatic esophageal mucocele that required resection.
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Enfermedades del Esófago , Mucocele , Femenino , Humanos , Mucocele/diagnóstico por imagen , Mucocele/etiología , Mucocele/cirugía , Estudios Retrospectivos , Enfermedades del Esófago/cirugía , Enfermedades del Esófago/complicaciones , DrenajeAsunto(s)
Humanos , Masculino , Adulto , Traumatismos Abdominales/complicaciones , Dolor en el Pecho/complicaciones , Trastornos de Deglución/complicaciones , Enfermedades del Esófago/complicaciones , Enfermedades del Esófago/etiología , Hematoma/diagnóstico por imagen , Hematoma/etiología , Hematoma/terapiaRESUMEN
Introduction: esophageal anastomosis dehiscence is a serious complication after esophageal cancer surgery with high mortality risk. One of the treatment options is self-expanding esophageal prostheses. Our aim was to evaluate the outcome of esophageal prostheses in the management of suture dehiscences after oncologic surgery.Material and methods: we performed a descriptive and retrospective study with patients diagnosed with esophageal anastomosis fistula or dehiscence treated by esophageal prosthesis between the years 2015 and 2021. We considered technical success as the correct positioning of the prosthesis with visualization of anastomotic leak closure after release of the prosthesis during endoscopy, and clinical success the resolution of dehiscence after removal of the prosthesis 8 weeks after positioning.Results: technical success was 95% and clinical success 89%.Conclusion: in our center, esophageal prostheses are a treatment option for fistulas and anastomotic dehiscence after surgery with a high success rate and few complications. (AU)