ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

We compared radiology and endoscopy in 80 patients with peptic esophageal stricture, with special attention to radiographic sensitivity for stricture caliber. Each stricture was classified by length into three types: 1) short (6–25 mm in length); 2) annular (under 6 mm in length); and 3) long (over 25 mm in length). Overall, radiology detected 95% of all strictures, including 90% of those over 1 cm in caliber. Morphologically, 75% of all strictures were short; 14% annular, and 11% long. Radiographically, smooth-stricture margins reliably excluded active esophagitis, while irregularity correlated well with its presence. Properly performed, barium esophagram can accurately detect esophageal strictures with a sensitivity approximating that of endoscopy.

ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

In fifteen patients with achalasia, we measured lower esophageal sphincter pressures before and after 5 mg of sublingual isosorbide dinitrate. The mean pressure fell significantly, from 36.5 to 18.4 mm Hg (P <0.01). The effectiveness of this therapy was confirmed by gamma camera measurement of the esophageal emptying time of a radionuclide test meal which was significantly less after the medication (P <0.05). The emptying time was invariably longer than 10 minutes before therapy, and in 12 of the 15 patients decreased after therapy to 1–8 minutes, corresponding to the clinical response to the drug therapy. The noninvasive radionuclide technique provides a simple way of assessing the results of drug therapy in achalasia.

ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

We suggest an approach to patients with gastric polyps, based on a study of 73 patients seen at this institution over a 5-year period. There were 40 cases of adenomatous and 20 cases of hamartomatous polyps. Differentiation between these two groups of polyps was not possible on the basis of clinical presentation, laboratory data, radiological, or endoscopic appearance. Differentiation was possible only on histologic examination of a totally resected specimen. In this series, only the adenomatous polyps were associated with gastric cancers in five patients. Since the malignancy either preceded or followed the recognition of adenomatous polyps, it is important to establish an early definite histological diagnosis. Patients with known adenomatous polyps should be followed closely for the development of gastric carcinoma, even after the polyps have been removed.

ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

A 52-year-old man who presented a perplexing diagnostic challenge, had diffuse linitis plastica involving the entire gastrointestinal tract. We review the literature and discuss the pathology of this disorder.

ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Duodenal neoplasms are a rare and not often considered cause of massive upper gastrointestinal bleeding. During a 4-year period, 850 endoscopies in patients with upper gastrointestinal bleeding revealed a duodenal tumor to be the cause of bleeding in eight patients. Three patients had a primary duodenal neoplasm, two had metastatic involvement, and in three others pancreatic tumors had invaded the duodenum. In view of our findings, we recommend careful endoscopic scrutiny of all parts of the duodenum in patients with upper gastrointestinal bleeding especially when the cause of bleeding is not found in the esophagus, stomach, or duodenal bulb.

ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Three cases of IHPS are presented in which an ulcer or a local irritant was an associated factor. Mucosal irritation leading to pyloric and antral spasm and then to muscular hypertrophy and obstruction is a possible explanation for the pathogenesis of the disease observed in these three infants. A review of the literature also leads us to conclude that IHPS is an acquired disease with a genetic or familial predisposition. Peptic ulcer may be an etiologic factor in some instances; however, the presence of a small ulcer is difficult to demonstrate in the majority of clinical cases.

ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

A case of mediastinal pseudocyst is reported. The hospital course and pathologic anatomy illustrate the often delayed diagnosis as well as the complications. The many thoracic sequelae, which mislead the clinician, are described. However, the finding of a right pleural effusion containing a high amylase level strongly suggests that a pancreatic etiology should be sought.

ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Patients with cirrhosis and hematemesis present a challenging problem. One overlooked and potentially reversible cause of hematemesis in these patients is epistaxis. We describe two such cases and review the literature with particular emphasis on emergency treatment.

ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

A 33-year-old woman with clinical and radiologic abnormalities interpreted as primary sclerosing cholangitis died of hepatic failure. Unexpectedly, the autopsy revealed focal dilatation of intrahepatic bile ducts (Caroli's disease) with cholangiocarcinoma. We know of only four previous cases of cholangiocarcinoma complicating focal dilatation of intrahepatic bile ducts. The lumen of the common hepatic duct and that of the common bile duct was narrowed by striking periductal fibrosis. Although tumor was found in the vicinity of these ducts, the periductal fibrotic sleeves were free of neoplastic tissue. These extrahepatic changes still may have been tumor-related, but they also may have been another, hitherto unobserved, manifestation of the fibropolycystic hepatobiliary diseases.

ISSN:0192-0790    

出版商:OVID    

年代:1982

数据来源: OVID