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Table of contents :
| Anatomical classification : | Symptoms, signs, and syndromes :
|
Diseases of the esophagus
or Down syndrome
within 24-48 hours
within 24-48 hours
in type I and type III (60%)
stops after 10 cm,
air in stomach is found in type III, IV, and V (distended, tympanic abdomen)
but not in type I (depressed, dull abdomen)
shows pulmonary atelectasis or bronchopneumonia
for excessive gastric distension (in type III and high-risk newborns)
since month 8-12 of age : cervical esophagostomy + gastrostomy.
is extremely rareref.;
aspiration
pneumonia
ref
(expecially tubercolar lymphadenitis)
who undergo EGD examinations. The prevalence of Cameron lesions seems to
be dependent on the size of the hernia sac, with an increased prevalence
the larger the hernia sac. In about 66% of the cases, multiple Cameron
lesions are noted rather than a solitary erosion or ulcer
=> empyema of mediastinum and usually pleural
empyema
(chagasic achalasia)
concentrations
and ESCC (RR =
33 for chagasic achalasia)
infiltrations)
followed by sub aortic esophagogastrostomy
followed by cervical transmediastinal anterior esophagogastroplasty.
Overlying mucosa is thinned.
with up to 2 liters of cold physiological solution with addedd antacids]
=>,
vasopressin
or Sengstaken-Blakemore
tube
=>
=>
(timolol) are ineffective in preventing varices in unselected patients
with cirrhosis and portal hypertension and are associated with an increased
number of adverse eventsref
,
resulting in abdominal distention or belching,
often interpreted by the patient as signs of a physical disorder),
defective esophageal clearance)
during meals
occurring in children as a symptom of reflux esophagitis or hiatal
hernia
has sensitivity = 90% and specificity = 10% ; only in cases with atypical
symptoms,
hiatal
hernia, gastric emptying, thickening of esophageal walls
: lansoprazole 20 mg/day resolves symptoms in 1-2 months; 25% of patients
using metachlopramide (10 mg 3 times a day) experience CNS side effects/hematemesis/melena
=> sideropenic anemia,
hypoproteinemia
(Candida esophagitis)
or peritonitis
(TOC) / palmoplantar ectodermal dysplasia type III,
c-MYC) and inactivation of several tumor suppressor genes. LOH on chromosome
17q25-qter, telomeric to the keratin II gene cluster, has been linked with
tylosis, a rare autosomal dominant syndrome associated with high predisposition
to ESCC. Whether this locus is also involved in sporadic ESCC remains to
be elucidated. Chronic esophagitis is a frequent occurrence in populations
at high risk of ESCC. These lesions often show focal accumulation of p53
protein and in some instances, patches of positive cells in esophagitis
area at the margins of tumors were found to contain a mutation in the p53
gene
(differential diagnosis with sarcomas with IHC for epithelial cytokeratins).
Its prevalence is increasing at the most rapid rate of any cancer in the
USA
-like
carcinoma (LELC) of the esophagusref
(from melanocytes in basal layers of oesophagus)
is exceptionally rare. A dozen or so esophageal carcinoids have been reported.
On the whole, prognosis is poor, and most tumors metastasize.
in von Trendelenburg's
position
shows ulcers or vegetations
=> biopsy
or MRI
for staging (longitudinal and transverse spreading in lymph nodes, metastases
to liver and lungs)|
|
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| cervical esophagus cancer |
|
|
|
| upper thoracic esophagus cancer |
|
|
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| midthoracic esophagus cancer |
|
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| lower thoracic esophagus cancer |
|
60-70 Gy (SCC is a radiosensitive tumor) in unresectable tumors
> 5-FU
> mitomycin C
> vincristine
> bleomycin
(partial and short-lasting response in 50%)
or mucosal resection has become attractive for many of these patients with
co-morbidity
:
with electrodes in small gastric curve and LES (distances from incisors
are taken by endoscopy). It detects :
in von Trendelenburg's
position.
It is expecially useful to detect spastic oesophagitis, undiagnosticable
by oesophagoscopy.
for submucosal tumors/
gastropathy / gastrosis
;
because they may bleed intermittently, and only be endoscopically evident
during hemorrhage, their diagnosis can be challenging because of its small
size and hidden location; multislice helical CTref
injection plus heater probe coagulation is significantly superior to epinephrine
injection alone in achieving hemostasis. Embolotherapyref,
endoscopic sclerotherapyref,
histoacryl injection, endoscopic hemoclipping, and endoscopic band ligation
(EBL)ref
are safe and effective alternate therapiesref.
Long-term recurrence was not evident following endoscopic ablation. Follow-up
after ablative therapy appears unnecessaryref.
.
and gastrojejunostomy,
or nasogastric tube
feeding
,
often a sensation of warmth, and sometimes diarrhea
due to hypertonic gastrorrhea
=> hyperinsulinemia after 3 hours => late hypoglycemia
which creates a large passage, but has the inconvenience of a marginal
ulcer or the late recurrence of the stenosis (narrowing of the gastrojejunostomy
due to the decrease of the gastric dilatation)
and a funnel shaped reconstruction. The upper part of this funnel is located
at the level of the major gastric curvature favoring gravitational drainage
to the duodenum through the gastroduodenal anastomosis.
during CPR
either direct (e.g. for pertussis post-exposure prophylaxisref1,
ref2,
ref3,
ref4,
ref5,
ref6,
ref7,
ref8,
ref9,
ref10,
ref11)
or through breast milk after maternal postnatal use of macrolidesref
(erythromycin (EM) is a MTLR1
agonist with prokinetic effect at low doses (1-3 mg/kg) used for for feeding
intolerance in preterm infants : motilin, a gastrointestinal peptide, stimulates
propagative contractile activity during phase III of the migratory motor
complex in the interdigestive stateref1,
ref2)
(as this is a dynamic condition, it should not be excluded after a single
negative examination; also used for prenatal diagnosis) shows thickening
> 4.1 +/- 1.1 mm and enlengthnment > 13.6 +/- 2.5 mm
in an avascular region (also in laparoscopy)
)
following fibrous stenosis.).
Silk suture should be avoided when constructing surgical gastrostomies.
When the tube is in place for > 9 months before removal the incidence of
GCF can be as high as 45%
is injected subcutaneously to stimulate gastric secretion
of the stomach associated with well-differentiated adenocarcinoma of
the transverse colonref
: in body and fundus of stomach, with pyloric and intestinal metaplasia.
The great angular incision of the small curve has increased susceptibility
due to-producing
epithelium
infection. Hypertone of pyloric sphincter => delay in gastric emptying
causes H+ hypersecretion.,
particularly to cows' milk
,
iron
deficiency anemia,
elevated levels of serum IgE, and protein-losing
enteropathy.)
(inhibits acid secretion, stimulates mucosal restitution after injury (cell
migration and proliferation), and augments gastric mucin levels) => fundic
gland hyperplasia, hypochlorhydria, increased gastric mucus => diffuse
enlargement and thickening gastric folds => marked protein losing gastropathy;
inflammatory changes may be associated => premalignant disorder
and generalized edema, epigastric pain, and weight loss. During childhood,
the main features of this condition include an abrupt onset and a spontaneous
recovery in a 2-3 weeks time.
series cannot distinguish between carcinoma of the stomach with certainty,
high fecal a1-antitrypsin excretion
(a marker of the protein-losing enteropathy)
infection
/ adenomatous polyp of the stomach : a type of adenomatous polyp usually
found in the antrum of the stomach, with branching tubules or fingerlike
projections and glandular tissue; it may be premalignant (with intraepithelial
neoplasia) or a sign of malignancy nearby. Usually single and sexile.,
usually of the stomach, in which the cells are polygonal rather than spindle-shaped,
ATM5, BRCA2, blood group A-857
T allele was found in 15.1% of patients with low-grade lymphoma and
9.1% of H. pylori-infected patients. Carrier of the rare allele
T had a 1.8-fold increased risk to develop low-grade lymphoma. Patients
with high-grade lymphoma were significantly more frequent carriers of the
TNF-857 T allele than healthy blood donors (30.9%vs 18.9%). Carriage of
the T allele conferred a 1.9-fold increased risk. There were no associations
found between any of the SNPs and disease progressionref,
Cu]field,
[NO3-]H2O)),
ethanol,
tobacco
chewing and smoking)
infection lasting > 10 years => atrophic
gastritis => production of NO. and increased cell proliferation,
increased pH => colonization by reductase+ anaerobic bacteria
which reduce dietary nitrates into nitrites.
The incidence of gastric cancer after a follow-up of 7.5 years (July 194-January
2002) is similar among people who received H.pylori eradication
treatment (a 2-week course of omeprazole, 20 mg, a combination product
of amoxicillin and clavulanate potassium, 750 mg, and metronidazole, 400
mg, all twice daily) and those who received placebo (7 and 11 cases out
of 1,630 chronic carrier - 988 of whom did not have any precancerous lesions,
as determined by endoscopic evaluation - in the high-risk Fujian Province
of southern China). In those carriers who do not have precancerous lesions,
however, eradication of H.pylori seemed to prevent the development
of gastric cancer - none of the treated patients developed gastric cancer,
whereas 6 in the placebo group did itref.,
induces death of most normal stomach cells and repopulation of the stomach
with BMDCs. Subsequently, these cells progress through metaplasia and dysplasia
to intraepithelial cancer. The researchers wiped out the animals' own bone
marrow with radiation and then infused them with fresh BMDCs. These were
labelled with GFP so that they could be tracked through the body. 20 weeks
after the mice were infected with H. pylori, some of the BMDCs had
homed in on the stomach and divided, and tumours had formed. Cancers are
spawned by cells from the bone marrow rather than ones already resident
in the stomach, and the researchers believe this may apply to humans too.These
findings suggest that epithelial cancers can originate from marrow-derived
sources, rather than from gastric stem cells contained in the lining of
the stomach, and thus have broad implications for the multistep model of
cancer progressionref.
Besides stomach cancers, the results suggest that bone-marrow cells may
be the starting point for many other cancers linked to infection and inflammation.
These include cancers of the oesophagus, lung, colon, cervix and liver,
in which BMDCs may also infiltrate the inflamed tissue. The study also
raises a cautionary note for doctors who are using injections of BMDCs
as experimental therapy for treating heart disease and other conditions
: such an infusion might increase the risks of these cells lodging in the
stomach or another inflamed area and triggering cancer.
,
laryngeal
nerve paralysis
=> dysphonia, cough, hemoptysis,
hematemesis,
laterocervical
lymphadenitis,
affects patients aged < 50 years, no prod