BACKGROUND AND OBJECTIVES Superior mesenteric artery (SMA) syndrome is a rare disorder, recognized as weight loss, nausea, vomiting, and post-prandial pain due to compression and partial obstruction of the third portion of the duodenum by the SMA. If conservative treatment fails, then laparotomy with duodenojejunostomy or lysis of the ligament of Treitz is indicated. Recently, laparoscopic divi...

OBJECTIVE To assess our results of a prospective algorithm applied to patients with thoracic esophageal perforation. METHODS A retrospective review of a prospective algorithm. Patients with esophageal perforation underwent an esophagram. If there was a contained esophageal perforation they were admitted, kept nothing by mouth, and restudied in 3-5 days. If the leak was not contained, they und...

Idiopathic pneumomediastinum is rare in children. Few cases of patients with pneumomediastinum show negative findings on X-ray examination. Chest computed tomography (CT) was very useful for the diagnosis and evaluation of the extent of pneumomediastinum. We report here a case of idiopathic pneumomediastinum in a 15-year-old boy who exhibited no significant chest X-ray finding. The patient was ...

TOPIC: Disorders of the Mediastinum TYPE: Fellow Case Reports INTRODUCTION: Tracheo-esophageal fistula is a rare but known acquired complication in patients with esophageal malignancy. A broncho-gastric an even rarer that can occur who undergo esophagectomy esophago-gastric anastomosis thoracic cavity (1). It important to recognize it early as lead serious complications like recurrent pneumonia...

Acute massive gastric dilation represents the extreme form of acute gastric dilation (AGD). Obstruction of distal duodenum can cause AGD with bilious nasogastric drainage. Most common causes are pancreatic neoplasms and pseudocysts, annular pancreas, superior mesenteric artery syndrome, retroperitoneal fibrosis and tumors, duodenal neoplasms and hematoma [1]. AGD complicated with gastric perfor...

An 86-year-old woman was admitted to the emergency room with a self-inflicted 3-cm horizontal wound to the left lateral side of her neck between the cricoid inferiorly and the angle of themandible superiorly. Pain, tenderness, and bloody saliva suggested a penetrating zone II neck perforation [1]. No signs of significant injury, such as severe active hemorrhage, bruit, pulse deficit, hoarseness...

We report on a 63-year-old man with a history of coronary artery bypass in 1995 who presented with massive hematemesis and hemodynamic instability. A computed tomography (CT) scan revealed a thoracic aortic pseudoaneurysm causing a mass effect on the esophagus (●" Fig.1) and rupture of the aorta immediately after the origin of the left subclavian artery, with the suspicion of an aortoesophageal...

CASE PRESENTATION A 58-year-old Hispanic man presented to the emergency department at Baylor University Medical Center complaining of a 1-year history of intermittent abdominal pain associated with occasional nausea and vomiting. He had been seen previously in another emergency department for this pain and had been treated with oral antibiotics and discharged home. However, he did not have a pr...

SIR, We read with great interest Dr Bradley's first reported case of pneumomediastinum in an adult with dermatomyositis.' We describe here a similar event, where spontaneous pneumomediastinum occurred in a patient with dermatomyositis and persisted for five months. In January 1986 a 20 year old man was admitted to hospital for assessment of recent generalised muscle, weakness. Examination showe...

Gallstone ileus is a rare cause of mechanical bowel obstruction due to the passage of a solitary large gallstone into the gastrointestinal tract through a cholecystoenteric fistula [1]. Early surgical intervention is the treatment of choice; however, the surgical mortality rate is high as most patients are elderly and many suffer from concomitant diseases [2]. Ultrasound-guided extracorporeal s...