• Title/Summary/Keyword: 부식성식도염

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Carcinoma of Esophagus Developing at the Site of Lye Stricture (부식성 식도염에 의한 협착부에 발생한 식도암)

  • 김종훈;김중강;백준기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.10.4-10
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    • 1979
  • The cause of esophageal cancer is still unknown in the majority of patients, but pre-existing diseases of esophagus related to the development of cancer were reported by many authors: e.g. lye stricture, achalasia, Plummer-Vinson syndrome, dietary and alocholic habbits etc. Recently the authors had experienced one case of esophageal cancer with complaint of dysphagia, developing at the site of lye stricture, which was diagnosed by the esophagogram and esophagoscopic biopsy.

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BALLOON DILATATION OF ESOPHAGEAL STRICTURE (Balloon 확장술에 의한 식도협착증의 치료)

  • 윤성철;나인국;김형종;노영수;임현준;이길우
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.33-33
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    • 1991
  • 부식성 식도염에서 속발한 식도협착의 비외과적 치료법으로 사용되었던 종래의 각종 소식자를 이용한 확장술은 그 효과가 일시적이며 소아에서 시행시 많은 문제점이 있다. 근래들어 관상동맥, 요관, 대장 등의 협착에 사용되어온 balloon Catheter를 이용한 식도 확장술은 비교적 안전하고 효과적이어서 소아나 정도가 심한 식도협착의 치료에 큰 도움을 줄 수 있다. 본 교실에서는 최근 2년간 부식성 식도염 후 속발한 식도협착 6 례를 Balloon catheter 확장법으로 치료하여 아래와 같은 결과를 얻었기에 보고하는 바이다. 1) 전체 6명 중 남자가 4명 여자가 2명으로 평균 연령은 45.7세였다. 2) 부식제의 종류는 가성소다가 5명 초산이 1명이였다. 3) 협착부위는 1례가 경부식도이며 5례가 흉부식도였고 이중 1례는 다발성 협착이 였다. 4) 확장 전 식도조영사진 상 협착부위의 평균 내경은 4.3mm였다. 5) 확장술을 시행한 횟수는 2회에서 5회( 평균 3.5회 )로 확장술이 끝난 후의 평균 내경은 13.5mm였다. 5) 확장술시 3례에서 식도파열이 발생하였으나 보존적 치료법으로 치유되었다.

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Mucosal Resection in the Corrosive Esophageal Stricture -A new technique- (부식성 식도 협착에서 식도 점막 절제술)

  • 김공수;구자홍;박상철
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.194-197
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    • 2001
  • 부식성 물질에 의한 양성 식도 협착 환자에서 식도 확장술이 일반적으로 사용되는 술식이나 협착부위가 잔존하여 연하곤란이 발생하므로 식도 재건술이 이용된다. 식도재건술은 대용 식도로 위관, 대장관, 소장관이 이용하여 광범위한 박리, 여러 부위의 절개, 문합부 대용 식도 위치에 따른 문제점 및 협착된 식도를 잔존시킴으로 식도암 발생가능성이 있으며 식도 재건술후 식도 기능의 문제점이 많다. 이에 시고 기능에 이상을 초래하지 않으면서 합병증이 적고 수술하기 쉬운 방법이 요구된다. 저자는 식도 근층만을 절개하고 점막하층을 박리한 후 협착부 점막만 절제하고 점막 단단 문합함으로 좋은 결과를 얻었기에 증례와 더불어 수술 방법을 소개하고자 한다.

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Significance of Early Esophagoscopy in Corrosive Esophagitis (부식성 식도염에서의 조기 식도경술의 의의)

  • 임병석;봉정표;박순일;문태용;윤강묵
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.12.2-13
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    • 1983
  • Corrosive injuries of the esophagus by accident or suicidal attempt, though decreasing in number, still represent an important problem of our national pathology. One of the most difficult problems facing any physician is the diagnosis and management of caustic ingestion. In order to determine the extent of esophageal bums, to prevent the potential complication, to increase the therapeutic effect, the use of esophagoscopy is an essential step, and it has lessened an unnecessary admission and treatment. The authors have found the value of early esophagoscopy in selected 41 corrosive esophagitis patient who were admitted to Dept. of ENT, Wonju medical college, Yonsei university between 1980. 1-1982. 12

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Jejunal Free Graft for Complicated Corrosive Esophageal Stricture (유리공장이식편을 이용한 합병된 부식성 식도협착의 재건술)

  • I Hoseok;Lee Sungsoo;Shim Young Mog
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.445-449
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    • 2005
  • The management of failure of colonic graft or corrosive stricture with impaired colonic circulation continues to be a challenge to surgeons. We present four cases of complicated corrosive esophageal stricture, which were successfully treated using jejunal free graft. As the initial surgical treatment, three patients underwent colonic interposition, and one underwent Whipple's procedure due to panperitonitis. Ore patient underwent transposition of jejunal free patch graft, two underwent interposition of jejunal free graft, and one underwent esophagojejunocolojejunostomy using jejunal free graft. All patients did not show dysphagia after long term follow-up. Complex esophageal reconstruction with jejunal free graft was performed successfully and long term functional outcome was good.

A Clinical Observation on Children with Corrosive Esophagitis (소아 부식성 식도염의 임상적 고찰)

  • Choi, Dong-Hyeon;Cho, Moon-Gi;Ju, Hyo-Geun;Kim, Byung-Ju;Ma, Jae-Sook
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.1-8
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    • 2000
  • Purpose: This study was undertaken to evaluate the clinical features and complication such as esophageal stricture in children with corrosive esophagitis. Methods: We retrospectively reviewed medical records of 31 children who accidentally ingested corrosive materials and visited to emergency room of Chonnam National University Hospital from Jan. 1992 to Dec. 1999. Twenty-one children were examined by upper gastrointestinal (UGI) endoscopy to evaluate location and severity of caustic injury. Results: 1) Among 31 patients, there were 20 males and 11 females and the ratio of male to female was 2:1. Average age at diagnosis was 2.3 years (12 months to 9.8 years). Twenty-seven (87.1%) patients were accidentally ingested vinegar. 2) Initial presenting symptoms were dysphagia (54.8%), vomiting (48.3%), chemical burn on lips and skin (45.2%), excessive salivation (45.2%), coughing and respiratory grunting (32.3%) and aspiration pneumonia (9.8%). 3) UGI endoscopic examination showed caustic injury in 17 children: grade I in 8, grade II in 7 and grade III in 2. The region of caustic injury was proximal esophagus in 5, distal esophagus in 3, entire esophagus in 9 and stomach in 6. 4) Corrosive esophageal strictures developed in 6 children (19.4%) and gastric outlet stricture in 1 (3.2%). All of them showed grade II or III caustic injury on endoscopic examination. Conclusion: The development of esophageal stricture was related to the severity of the caustic injury. Early UGI endoscopic examination in caustic ingestion seems to be useful for prediction of development of caustic stricture.

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BASKET EXTRACTION OF ESOPHAGEAL FOREIGN BODY - REPORT OF 2 CASES - (Basket을 이용한 다발성 식도협착환자의 식도이물제거술 2례)

  • 최홍식;김영명;임상빈;김영모;김기황
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.17.2-17
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    • 1987
  • 식도이물은 이비인후과 영역에서 흔히 경험할 수 있는 것으로 연령, 성별, 민족 등에 제한없이 발생할 수 있으며, 대부분의 경우 예기치 않게 돌발적이며 부주의로 인하여 발생되는 경우가 많다. 이물은 일상생활과 밀접한 관계가 있는 것으로서 그 종류가 매우 다양하다. 대부분의 식도이물의 경우, 진단 및 치료가 용이하나, 경우에 따라서는 이물의 종류, 개재부위, 체류기간, 선행질병 및 증상 등에 따라 진단 및 치료가 용이하지 않은 경우도 있다. 특히 다발성 식도협착이 있는 환자의 원위(distal) 협착부위에 개재한 식도이물은 식도경이 근위(proximal)협착부를 통과할 수 없으므로 이물제거가 상당히 힘들 경우가 많다. 저자들은 최근 부식성 식도염에 속발한 다발성 식도협착이 있는 2명의 환자에서 원위협착부위에 개재한 식도이물을 fluoroscopy 도움하에서 Medi-Tech biliary basket을 사용하여 제거하였기에 문헌적 고찰과 함께 보고하는 바이다.

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The Clinico-Statistical Analysis of Dysphagia (연하곤란을 주소. 내원한 환자의 임상통계적 고찰)

  • 윤태현;선우대활;고건성;김진영
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1978.06a
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    • pp.6.1-6
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    • 1978
  • Dsysphagia or difficulty in swallowing is a symptom wich indicates the presence of disease or dysfunction. Because the cause & the original site are variable, it is significant to study the clinicostatistical analysis on 133 cases with complant of dysphagia during the last one year in the department of Otolaryngology, College of Medicine, Seoul National University. The results are as follows; 1) Among the total O.P.D. patients (6313 cases), patients complaining the dysphagia are 2.1%. 2) Male to female sex ratio is 1. 3 to 1, slightly predominent in male and average are 35.7 years. 3) The duration of chief complaint is about 251 days in average, but excluding the 8 cases with more than year of symptom, it is about 40 days. In detailed analysis of the duration; 67 cases (50.4%) occurred within 1 weak: 24 cases (18.0%), 1 week to 1 month: 34 cases (25.6%), 1 month to 1 year: 8 cases (6.0%), more than 1 year. 4) As to the site of origin, the oropharyngolaryngeal origin 106 cases (76.7%) are 4 times as many as the esophageal origin 27 cases (20.3%). 5) As to the etiological classification: inflammation 67 cases (50.4%), tumor 28 cases (21.0%), corrosive agent 14 cases (10.5%), foreign body 11 cases (8.3%) in order. 6) As to the disease entity: pharyngitis and tonsillitis 42 cases (31.6%), stomatitis 14 cases (10.5%), corrosive esophagitis 14 cases (10.5%), laryngeal tumor 12 cases (9.0%), peritonsillar abscess 9 cases (6.8%), esophageal foreign body 7 cases (5.2%), tongue tumor 7 cases (5.2%), tonsillar tumor 6 cases (4.5%), (pharyngeal foreign body 4 cases (3.0%)in order.

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Reconstructive Surgery for Caustic Esophageal Stricture (II) (부식성 식도협착에 대한 식도 재건술(II))

  • 정승혁;강경민
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.420-426
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    • 1996
  • We previously reported 344 cases of esophageal reconstruction for caustic esophageal stricture between 1959 and 1982, and this is the second report of 69 cases during 12 year period from Jan. 1983 to Feb. 1995. There were 32 males and 37 females, ranging in age from 4 to 65 years(mean 36.4 years). Caustic materials were acid in 37 (53.7%) and alkali in 31 (44.9%). All cases underwent colon interposition without esophageal resection except 3 cases of cancer complication which were resected through thoracotomy. In 64 cases isoperistaltic right colon with teminal ileum interposition were performed, and 5 cases were interposed with left colon either isoperistaltic (2 cases) or antiperistaltic (3 cases) method. Anastomotic leakage was the most frequently encountered c mplication (14.4%, 10 cases), and they were 11.6%(8 cases) from cervical, 2.8% (2 cases) from ileocolostoma. Overall operative mortality was 2.9% (2169), main causes of death were sepsis due to graft necrosis and mediastinitis. During 6 months to 12years (mean 2.Syears) follow-up of survived 67 cases, 88.1% (59 cases) ate normally, 7.5% (5 cases) complained of moderate dysphagia (eating liquid diet), and 4.5% (3 cases) were unable to eat by mouth. In our experience, reconstruction of the esphagus with the colon is a satisfactory method that can be accomplished with acceptable morbidity and mortality. The right colon is a durable and functional esophageal substitute.

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Clinical Study of Corrosive Esophagitis (부식성 식도염에 관한 임상적 고찰)

  • 이원상;정승규;최홍식;김상기;김광문;홍원표
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.6-7
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    • 1981
  • With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

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