• Title/Summary/Keyword: stricture

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Surgical Treatment of Achalasia of the Esophagus -Report of 9 Cases Performed Modified Heller Operation- (Achalasia 의 외과적 치료 -Modified Heller Operation을 시행한 9례의 관찰성적-)

  • 이호일
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.53-60
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    • 1968
  • Achalasia is a functional disorder of a short segment of the lower esophagus showing obstruction of the esophagogastric junction. Dysphagia. regurgitation and weight loss are outstanding features,however, complicated pulmonary troubles aspiration pneumonitis, bronchiectasis, lung abscess etc. --are sometimes more apparent than the disease entity in children though achalasia is rarely encountered in children. During the period of January, 1961, to May, 1968, the authors experienced 9 cases of achalasia of the esophagus in Chest Surgery Department,N.M.C. 1. Seven of nine were male and four were under 5 years of age. 2. So-called symptoms triad noted in almost every case, and 3 of 4 children showed recurrent attacks of pneumonitis. 3. Chest film showed widened superior mediastinum by dilated esophagus in 6 cases, and pulmonary infiltrations in 3 cases of children. 4. Preoperative diagnosis were achalasia,esophageal stricture by rodent-cidal ingestion and suggestive esophageal cancer in 7 cases,one case and remaining one case. respectively. 5. Modified Heller procedure was performed in all cases with definite diagnosis of achalasia at operation table in misdiagnosed 2 cases. 6. Immediate postoperative complications were 2 cases of wound infection and one case of atelectasis and no operative mortality encountered. 7. Seven of nine showed excellent result of operation, and good in one case. Remaining one case failed relieving obstruction and underwent interposition of ileocolonic segment with excellent result.

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Aorto-Esophageal Fistula Complicated by Esophageal Metalic Stent -A case report- (식도 내 금속 스텐트 삽입 후 발생한 대동맥 식도 누공 -치험 1례-)

  • 윤영철;조광현;김기봉;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.479-482
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    • 2002
  • Aortoesophageal fistula induced by endoesophageal stent is rare; however, it is usually a fatal disorder, with few survivors reported. We report a case of a 32-year old female with aortoesophageal fistula after insertion of the esophageal stent in esophageal lye stricture who was successfully diagnosed with endoscopy and treated in a two-stage operation. In the first stage, we performed esophagectomy, primary repair of the fistula site in the descending thoracic aorta, and feeding gastrostomy. After the patient recovered well postoperatively, a retrosternal interposition of the right colon and cervical esophago-colo-grastostomy were performed, to re-establish the gastrointestinal tract.

Rewards, Satisfaction and Economic Trends under Nonlinear Assumption

  • KHALID, Komal;SH OAIB, Adnan
    • The Journal of Asian Finance, Economics and Business
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    • v.6 no.2
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    • pp.287-298
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    • 2019
  • The purpose of this study to investigate the impact of rewards on job satisfaction and whether economic trends moderate the relationship of job satisfaction and rewards or not. Furthermore, this study also investigates whether the relationship between job satisfaction and reward is linear or nonlinear and whether the relationship diminishes or improves with predictor inclusion. Data collection was done through online and self-administered questionnaires by adopting cluster sampling technique from higher education institutions of Pakistan. Results based on 2160 responses suggest that economic trends moderate the relationship of job satisfaction and reward while assuming the economic trends as perceived rewards. The logit model was adopted to probabilistic relationship between job satisfaction and reward in moderation with economics trends. The moderations magnify the impact of rewards on job satisfaction. The job satisfaction is more sensitive to extrinsic reward as compared to intrinsic reward. The relationship of job satisfaction and reward is nonlinear for both extrinsic and intrinsic reward suggesting the diminishing relationship of job satisfaction and rewards. This study has pivotal implication for the higher education sector as it helps the sector to align the rewards with economic and trends and can normalize the reward after assessing the nonlinear stricture of relationship.

Enterourachal Fistula as an Initial Presentation in Crohn Disease

  • Sankararaman, Senthilkumar;Sabe, Ramy;Sferra, Thomas J.;Khalili, Ali Salar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.90-97
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    • 2019
  • Crohn disease has a wide spectrum of clinical presentations and rarely can present with complications such as a bowel stricture or fistula. In this case report, we describe a 17-year-old male who presented with a history of recurrent anterior abdominal wall abscesses and dysuria. He was diagnosed with Crohn disease and also found to have a fistulous communication between the terminal ileum and a patent urachus. An ileocecectomy with primary anastomosis and complete resection of the abscess cavity was performed. He is on azathioprine for maintenance therapy and currently in remission. Clinicians should have a high index of suspicion for this complication in Crohn disease patients presenting with symptoms suggestive of urachal anomalies such as suprapubic abdominal pain, dysuria, umbilical discharge, and periumbilical mass.

Contrast-Enhanced Ultrasound and Shear Wave Elastography Evaluation of Crohn's Disease Activity in Three Adolescent Patients

  • Thimm, Matthew A;Cuffari, Carmen;Garcia, Alejandro;Sidhu, Sarah;Hwang, Misun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.3
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    • pp.282-290
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    • 2019
  • Characterizing inflammation and fibrosis in Crohn's disease (CD) is necessary to guide clinical management, but distinguishing the two remains challenging. Novel ultrasound (US) techniques: contrast-enhanced US (CEUS) and shear wave elastography (SWE) offer great potential in evaluating disease activity in pediatric patients. Three patients ages 16 to 20 with known CD underwent CEUS and SWE to characterize bowel wall inflammation and fibrosis. Magnetic resonance enterography, endoscopy, or surgical pathology findings are also described when available. The patients' disease activity included acute inflammation, chronic inflammation with stricture formation, and a fibrotic surgical anastomosis without inflammation. CEUS was useful in determining the degree of inflammation, and SWE identified bowel wall fibrosis. Used together these techniques allow for better characterization of the degree of fibrosis and inflammation in bowel strictures. With further validation CEUS and SWE may allow for improved characterization of bowel strictures and disease flares in pediatric patients suffering from CD.

The Semiotics and the Spectacles of Everyday Life in the Reality Entertainment (리얼리티 예능의 일상 스펙터클과 의미작용)

  • Oh, So Jeong
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.2
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    • pp.171-176
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    • 2021
  • This article analyze that the everyday life shown in reality entertainment, and examine the semiotics of reality entertainment and the everyday life. With the perspectives of Guy Debord and Olivier Razac, the everyday life in the reality entertainment be concluded the Spectacles of everyday life. And it brings to Barthes's structure of Myth, designs the stricture of reality entertainment. Unlike Debord and Razac, who only refer to the public as passive audience, today's consumers are capable of active interpretation and consumption-the active audience. Instead of criticizing only the media's adverse function, Spectacle, I would like to suggest that the everyday life story-telling of reality entertainment can be interpreted as the recovery of the audience.

Complete Transection of the Cystic Duct and Artery after Blunt Trauma: A Case Report

  • Cho, Sung Hoon;Lim, Kyoung Hoon
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.294-298
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    • 2021
  • Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

Congenital web of the common bile duct combined with multiple intrahepatic duct stricture: a case report of successful radiological intervention

  • Lim, Hanseul;Hwang, Shin;Ko, Gi-Young;Han, Hyejin
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.161-167
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    • 2022
  • Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. We herein report a case of common bile duct septum combined with multiple intrahepatic bile duct strictures in a 74-year-old female patient who was successfully treated with radiological intervention. The patient initially visited the hospital because of upper abdominal pain. Imaging studies revealed multifocal strictures with dilatation in both intra- and extrahepatic ducts; the final clinical diagnosis was congenital common bile duct web combined with multiple intrahepatic duct strictures. Surgical treatment was not indicated because multiple biliary strictures were untreatable, and the disease was clinically diagnosed as benign. The multiple strictures were extensively dilated twice through bilateral percutaneous transhepatic biliary drainage (PTBD) for 2 months. After 1 month of observation, PTBD catheters were successfully removed. The patient is doing well at 6 months after completion of the radiological intervention, with the maintenance of normal liver function. Congenital web of the bile duct is very rare, and its treatment may vary depending on the patterns of biliary stenosis. In cases where surgical intervention is not indicated for congenital web and its associated disease, radiological intervention with balloon dilatation can be a viable therapeutic option.

A Case of End-On Colostomy in a Dog Suffering from Dyschezia

  • Yeon-Jung Hong;Hyung-Kyu Chae;Sung-Jun Yoon;Kyoung-In Shin;Hyun-Min Hwang;Ju-Yeon Jung;Seongjin Yun;Byeong-Jun Jang;Oh-Kyeong Kweon
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.384-389
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    • 2022
  • A 12-year-old Shetland sheepdog with dyschezia was presented to the clinic. Dyschezia was considered to have been caused by rectal stricture due to a perianal mass containing the distal colon, rectum, and anus. Considering the histological findings and gross appearance of the perianal mass, an aggressive form of adenocarcinoma was diagnosed and a poor prognosis was expected. An endon colostomy was successfully performed to improve quality of life, which had been decreased by the dyschezia. Postoperative fecal evacuation was well-managed by the owner using a disposable colostomy bag in addition to a previously reported flange and drainable pouch. The dog survived for three months and had a satisfactory quality of life. Surgery and postoperative management in such cases will be helpful in the treatment of defecation disorders in animals.

Long-term complications after extrahepatic cyst excision for type IV-A choledochal cysts

  • Utpal Anand;Aaron George John;Rajeev Nayan Priyadarshi;Ramesh Kumar;Basant Narayan Singh;Kunal Parasar;Bindey Kumar
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.433-436
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    • 2023
  • Forty-five adults with type IV-A choledochal cysts (CDC) who underwent extrahepatic cyst excision from January 2013 to December 2021 were followed up for a median interval of 25 months (range, 2 to 10 years) to observe the long-term complications in the remaining intrahepatic cyst. Late complications in varying combinations were seen in 10 patients, which included cholangitis and/or intrahepatic stones in 9 patients, intrahepatic bile duct stenosis with stones in 2 patients, anastomotic stricture in 6 patients, and left lobar atrophy with intrahepatic stones in 3 patients. Out of 6 patients who required re-do hepaticojejunostomy (HJ), three patients had left lobe atrophy with patent HJ anastomosis and a recurrent attack of cholangitis on follow-up at 3, 8, and 10 years. Complications occur frequently after extrahepatic cyst excision for type IV-A CDC and require a long-term follow-up.