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Related Concept Videos

Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

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Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
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Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
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Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
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Long-gap esophageal atresia.

Hester F Shieh1, Russell W Jennings1

  • 1Department of Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Fegan 3, Boston, MA 02115.

Seminars in Pediatric Surgery
|May 29, 2017
PubMed
Summary

Managing long-gap esophageal atresia is complex, often requiring native esophagus preservation or replacement. Multidisciplinary centers ensure optimal treatment and follow-up for these challenging cases.

Keywords:
Esophageal atresiaGrowth inductionJejunal interpositionLong gap

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Long-gap esophageal atresia presents significant management challenges.
  • There is a lack of consensus on its definition, evaluation, and surgical treatment.
  • Native esophagus preservation strategies are evolving.

Purpose of the Study:

  • To review current management strategies for long-gap esophageal atresia.
  • To highlight the importance of multidisciplinary care for affected patients.

Main Methods:

  • Review of current literature and surgical techniques.
  • Discussion of esophageal preservation versus replacement options.
  • Emphasis on outcomes and follow-up protocols.

Main Results:

  • Delayed primary anastomosis and growth induction show success in native esophagus preservation.
  • Esophageal replacement is needed in a subset of patients, with outcomes varying by institutional expertise.
  • Multidisciplinary centers are crucial for managing complex cases and ensuring long-term outcomes.

Conclusions:

  • Effective management of long-gap esophageal atresia requires tailored approaches, balancing native esophagus preservation with replacement when necessary.
  • Multidisciplinary esophageal and airway treatment centers are essential for optimizing care and long-term follow-up in this high-morbidity patient group.