Esophageal perforation continues to be a difficult diagnostic and management problem. Recommendations regarding treatment remain controversial. 17 patients with perforation of the esophagus were retrospectively reviewed at the Thoracic Surgery Unit of Imam Khomeini Hospital between 1981 and 1992. The majority of the injuries involved the thoracic esophagus (10 or 59%), followed by the cerv...

esophago-pulmonary fistula after esophagectomy Anastomotic leakage, which is one of the complications of esophagectomy, sometimes causes a refractory fistula despite conservative therapy [1]. Polyglycolic acid (PGA) sheets (Neoveil; Gunze, Kyoto, Japan), a suture reinforcement material that is absorbed within 4–15 weeks, have been used in many fields of open and endoscopic surgery [2,3] to prev...

Duodenal perforation as complication of endoscopic retrograde cholangiopancreatography (ERCP) is a rare but serious secondary event with an incidence of 0.6%– 0.99% [1]. The most dangerous type of perforation is that categorized as type I in the classification by Stapfer et al. [2] and usually located in the lateral or medial duodenumwall. This is associated with high mortality rates (28%–47%) ...

Introduction: Peptic ulcer disease is still the major cause of gastro-intestinal perforation despite major improvements in both diagnostic and therapeutic strategies. While the diagnosis of a perforated ulcer is straightforward in typical cases, its clinical onset may be subtle because of co-morbidites and/or concurrent therapies. Case presentation: We report a case of a 53-year-old Caucasian m...

for replacement of a percutaneous endoscopic gastrostomy (PEG) tube. He had originally undergone PEG tube placement at our hospital 2 years ago, and after insertion the position of the hub had been checked by gastroscopy. However, placement of the most recent PEG tube had been done at another hospital 1 year ago, with no gastroscopic evaluation. When the patient attended our hospital 1 year lat...

An 82-year-old patient presented with a history of fever for 2 weeks and occasional rectal bleeding. He had undergone endovascular repair of a left internal iliac artery aneurysm (IIAA) 3 years previously (●" Fig.1); distal occlusion of the IIAA with coil embolization and proximal occlusion using an aorto–external iliac artery stent graft achieved successful exclusion of the IIAA (●" Fig.2). Co...

A 47-year-old man with squeezing nature chest pain visited the emergency department. His heart sounds were normal without murmurs, and no history of cardiovascular risk factors or previous heart disease. Initial electrocardiogram showed sinus tachycardia with elevation of ST segment in pre-cordial leads, and he complained of continuous chest pain. Emergent coronary angiography was performed but...

PURPOSE OF REVIEW This study aimed to systematically review small bowel obstruction (SBO), focusing on recent changes in diagnosis/therapy. RECENT FINDINGS SBO incidence is about 350,000/annum in the USA. Etiologies include adhesions (65%), hernias (10%), neoplasms (5%), Crohn's disease (5%), and other (15%). Bowel dilatation occurs proximal to obstruction primarily from swallowed air and sec...

PATIENT Female, 74. FINAL DIAGNOSIS Recurrent cholangitis. SYMPTOMS -. MEDICATION -. CLINICAL PROCEDURE -. SPECIALTY Gastroenterology and Hepatology. OBJECTIVE Unusual clinical course. BACKGROUND Cholangitis may result from biliary obstruction (e.g., biliary or anastomotic stenosis, or foreign bodies) or occur in the presence of normal biliary drainage. Although reflux of intestin...