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A 60-year-old woman complaining of abdominal discomfort was found at endoscopy to have a dome-shaped esophageal polyp, located 22cm from the incisor teeth and covered by normal epithelium. Histologic examination after endoscopic removal showed a submucosal esophageal gland adenoma. This is the ninth reported case of this entity. Eleven years later, the patient remains well with no evidence of esophageal...
A 25-year-old woman presented with dysphagia and chest pain in November 1999. Esophagography revealed esophageal stasis with spindle-shaped tapering at the cardia without dilatation of the lower esophagus. Manometry showed a hypertonic sphincter with incomplete relaxation on swallowing. Esophageal body contractions were simultaneous with an amplitude in excess of 200mmHg with tertiary contractions...
Methods. Between 1993 and 2000, 141 consecutive patients with primary thoracic esophageal cancer underwent radical esophagectomy. A total of 78 patients who underwent surgery between 1997 and 2000 received perioperative steroid therapy. Sixty-three patients who underwent surgery between 1993 and 1996 were analyzed as the control group. In the steroid group, 250mg methylprednisolone was administered...
We present a case of esophageal carcinoma in which esophagectomy was not possible because of tuberculous fibrosing mediastinitis. A 77-year-old man was diagnosed with carcinoma of the thoracic esophagus and admitted to our hospital. Chest radiography on admission revealed no abnormality except pleural thickening of the pulmonary apices, suggesting a history of subclinical infection of tuberculous...
Esophageal rupture is a potentially fatal condition. Rapid and correct diagnosis and urgent surgical treatment are mandatory. Various surgical treatment methods have been reported. We introduced a new surgical procedure for treatment of spontaneous esophageal rupture. Upon thoracotomy continuing to laparotomy, a T-tube was inserted into the esophageal lumen through the ruptured site. The ruptured...
Primary malignant melanoma of the esophagus is uncommon, and its prognosis is poor compared to that of cutaneous malignant melanoma. Here we describe a case of primary malignant melanoma of the esophagus with a long-term survival. A 52-year-old woman received an upper gastrointestinal endoscopy and an upper gastrointestinal series for a dull back pain and dysphagia. A pigmented polypoid tumor in the...
We report serious pleuropulmonary complications in a 6-year-old girl with an underlying extrahepatic biliary atresia who underwent esophageal varice sclerotherapy (EVS). The EVS was performed paravariceally with a 25-gauge disposable injection needle using polidocanol as a sclerosant. A total of 11 ml of the agent was injected in this session. The patient reported epigastric pain and developed a high...
These Guidelines originally were published by Kanehara & Co., Ltd., Tokyo, copyright 2001 by Kanehara & Co., Ltd., and the Japanese Society for Esophageal Diseases. They are reprinted here by permission of the copyright holders.
Advanced end-stage achalasia was treated by esophagus-preserving surgery in four women. Their median age was 46.5 years, and the median duration of symptoms was 17.0 years. Advanced end-stage achalasia was defined as esophageal dilatation to more than 6 cm in diameter and meandering on radiography. Myotomy, fundopexy, and posterior fixation with straightening of the lower esophagus were performed...
Esophageal cancer is becoming a different disease in Asian and Western countries. The rapidly rising incidence of adenocarcinoma of the lower esophagus and cardia has replaced squamous cell cancers as the predominant cell type in the west. The different cell type and tumor location to some extent influence how the disease is treated; other factors are cultural and the way health care is financed....
We report the case of a 72-year-old man with esophageal schwannoma who underwent the Ivor Lewis procedure. He suffered from dysphagia for 6 months. Esophagoscopy revealed a submucosal tumor bulging on the posterior wall 30 cm distant from the incisors. Endoscopic ultrasonography (EUS) revealed tumor located within the muscularis propria, the fourth layer of the esophageal wall. Upper gastrointestinal...
A 14-year-old girl was admitted to our hospital for treatment of abdominal pain after an attempt to commit suicide by swallowing a caustic soda solution. Severe esophageal stricture following corrosive esophagitis occurred 2 weeks after admission. First, we tried to dilate the stenotic esophagus by using an esophageal bougie, but it was not effective and was also painful, and the treatment was stopped...
Cancer of the esophagus and gastroesophageal junction (GEJ) in North America remains a relatively small but challenging clinical problem. It is estimated that, in 2004, 21 000 new esophageal cancers will be diagnosed (of which more than 75% will be in men) and 19 600 deaths from esophageal cancer will occur. In contrast to the Asian experience, adenocarcinomas of the esophagus and GEJ comprise more...
Esophageal cancer and its treatment differ largely between the West and the East because West and East are concerned – at least in part – with different diseases: squamous cell cancers are the prevailing tumor type in Japan and other parts of Asia whereas this entity is now clearly outnumbered in Europe and North America by esophageal adenocarcinoma. The latter are mostly Barrett’s cancers, arising...
Background To evaluate the treatment outcome of radiotherapy for nodal recurrence after definitive chemoradiotherapy for esophageal carcinoma. Methods Between 1996 and 2001, ten patients with isolated nodal recurrence after definitive chemoradiotherapy received radiotherapy with or without chemotherapy. The site of recurrence was the mediastinum in five patients, the celiac node in four patients,...
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