25 research outputs found
Noninvasive diagnosis of left ventricular outflow tract obstruction caused by a porcine mitral prosthesis
A patient developed shortness of breath 8 years after mitral valve replacement with a porcine prosthesis. Doppler echocardiography revealed left ventricular outflow tract obstruction created by a protruding prosthesis
Diagnosis and surveillance of Barrettās esophagus (BE)
Sp. Cl āSf. Mariaā, Clinica de Chirurgie GeneralÄ Či EsofagianÄ, BucureČti, RomĆ¢nia, Al XI-lea Congres al AsociaČiei Chirurgilor āNicolae Anestiadiā din Republica Moldova Či cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova āIacomi-RÄzeČuā 27-30 septembrie 2011Introducere: EB este o afecČiune ce apare Ć®n urma refluxului gastro-esofagian cronic Či care este factor de risc Ć®n apariČia adenocarcinomului esofagian.
Scop: evaluarea metodelor de diagnostic Či de urmÄrire a pacienČilor cu EB. Metoda: Ćn perioada 2006-2010, 36 de pacienČi au fost diagnosticaČi cu EB prin Endoscopie DigestivÄ SuperioarÄ (EDS) cu biopsie. S-a folosit manometria esofagianÄ Či pH-metria pe 24 ore pentru evaluarea rÄspunsului la tratament. PacienČii au primit 3-6 luni tratament medical. Ćn urma lipsei de rÄspuns sau a complianČei la tratamentul medical s-a efectuat tratament chirurgical. PacienČii au fost supravegheaČi conform protocoalelor. Rezultate: EDS a diagnosticat 15 pacienČi fÄrÄ leziuni asociate, 8 cu esofagitÄ grd.A-C, 8 cu hernie hiatalÄ asociatÄ, 2 cu ulcer esofagian Či 3 cu reflux biliar. Sfinterul esofagian inferior (SEI) incompetent Či pH-metrie modificatÄ au fost decelate la 3, respectiv 4 din pacienČii fÄrÄ leziuni asociate, la 5 din cei cu esofagitÄ Či la 8, respectiv 7 din cei cu hernie hiatalÄ. Examenul histologic a
decelat 2 pacienČi cu displazie low-grade. DupÄ tratamentul medical sau chirurgical s-a obČinut ameliorarea simptomatologiei Či vindecarea leziunilor de esofagitÄ. DupÄ fundoplicatura, parametrii pH-metrici Či manometrici au revenit la normal, iar dupÄ Diversie Duodenala TotalÄ s-a observat absenČa refluxului biliar esofagian. Concluzii: Diagnosticul Či supravegherea pacienČilor cu esofag Barrett sunt foarte importante datoritÄ riscului de evoluČie cÄtre adenocarcinom.Introduction: BE is a disease induced by chronic gastro-esophageal reflux and is a risk factor for the development of esophageal adenocarcinoma.
Aim: to evaluate the methods of diagnosis and follow-up of the patients with BEMethods: Between 2006 and 2010, 36 patients were diagnosed with BE
using Upper Endoscopy (UE) with multiple biopsies. We used esophageal manometry and 24 hours pH-metry for assessing the outcome. The patients
received initially for 3-6 month medical treatment. When lacking response or compliance at drug therapy, the surgical treatment was applied. The
patientās follow-up was made according to protocols.Results: The UE diagnosed 15 patients with no associated findings, 8 had grd.A-C esophagitis, 8
had hiatal hernia, 2 had esophageal ulcer and 3 presented biliar reflux. The lower esophageal sphincter (LES) was incompetent and the pH-metry was abnormal in 3, respective 4 of patients with no associated findings, in 5 of those with esophagitis and in 8, respective 7 of those with hiatal hernia. The
histological exam finds 2 patients with low-grade dysplasia. The improvement of symptomatology and the healing of esophagitis were noticed after
medical treatment and in all patients surgically treated. After fundoplication, the pH-metric and manometric values restored to normal and after total
duodenal diversion no more biliary reflux was noticed. Conclusions: The diagnosis and surveillance of Barrettās esophagus are very important due to
the risk of development of adenocarcinoma
Extension of adrenocortical carcinoma into the right atrium ā echocardiographic diagnosis: A case report
BACKGROUND: Adrenocortical carcinoma is a rare, highly malignant tumor. Cardiac involvement of the tumor is very rare. Echocardiography facilitates the evaluation of the cardiac involvement of the tumor. CASE PRESENTATION: We describe a patient with an adrenal tumor. Transthoracic echo showed its extension into the right atrium. Accordingly, a combined abdominal and cardiac operation was performed, monitored by transesophageal echocardiography. CONCLUSION: This case highlights the importance of echocardiography in revealing the cardiac involvement by this tumor and in planning the operative procedure
Towards screening Barrettās Oesophagus: current guidelines, imaging modalities and future developments
Barrettās oesophagus is the only known precursor to oesophageal adenocarcinoma (OAC). Although guidelines on the screening and surveillance exist in Barrettās oesophagus, the current strategies are inadequate. Oesophagogastroduodenoscopy (OGD) is the gold standard method in screening for Barrettās oesophagus. This invasive method is expensive with associated risks negating its use as a current screening tool for Barrettās oesophagus. This review explores current definitions, epidemiology, biomarkers, surveillance, and screening in Barrettās oesophagus. Imaging modalities applicable to this condition are discussed, in addition to future developments. There is an urgent need for an alternative non-invasive method of screening and/or surveillance which could be highly beneficial towards reducing waiting times, alleviating patient fears and reducing future costs in current healthcare services. Vibrational spectroscopy has been shown to be promising in categorising Barrettās oesophagus through to high-grade dysplasia (HGD) and OAC. These techniques need further validation through multicentre trials