INTRODUCTION Spontaneous gastric perforation is a well known surgical emergency which carries significant mortality and morbidity. Well documented causes in adults include peptic ulcer disease, drugs such as non-steroidal and gastric malignancy. Iatrogenic causes still remain relatively rare. We report an interesting case of an acutely unwell young man who developed gastric perforation seconda...

Laparoscopic gastric surgeries are routinely performed with use of a nasogastric tube to decompress the upper gastrointestinal tract. A distended upper gastrointestinal tract can complicate successful laparoscopic gastric surgery as the distention compromises not only the visual field but also the laparoscopic manipulation of the stomach. Since nasogastric intubation is not without risks, we ha...

Reflux after Ivor Lewis esophagectomy has a deleterious effect on anastomotic wound healing and is a risk for pulmonary aspiration [1]. We report endoscopic negative pressure therapy, using a novel double-lumen open-pore film drainage method, for prevention of postoperative reflux. A 70-year-old patient underwent Ivor Lewis esophagectomy because of carcinoma of the distal esophagus (pT2pN0), ha...

A simple, rapid and satisfactory method of investigating the gastric secretion in infants and children is of undoubted value in their clinical investigation. The difficulties experienced by the use of the ordinary methods in children necessitates a new approach. With the usual method of passing a gastric tube followed by a test meal, the psychical and physical disturbances which ensue must have...

A 55-year-old woman was found to have a depressed lesion on the posterior part of the lower gastric body (▶Fig. 1 a). The patient underwent endoscopic submucosal dissection (ESD) and en bloc resection without intraoperative perforation. Prophylactic endoscopic coagulation using Coagrasper (Olympus Medical, Tokyo, Japan) was performed for visible vessels, and endoclips were applied prophylactica...

Percutaneous endoscopic gastrostomy (PEG) is a minimally invasive procedure. However, failure to transilluminate the anterior wall of the stomach or visualize the indentation of the physician's finger represents the most frequent obstacles encountered by the endoscopist in safely completing PEG tube placement. We described several methods to safely assess PEG placement in high-risk patients. An...

A case of collision carcinoma (squamous cell carcinoma and Barrett's adenocarcinoma) in the residual cervical esophagus of a 68-year-old woman at 27 years after subtotal esophagectomy for thoracic esophageal carcinoma is reported. The patient initially noticed cervical dysphagia in 2002, but did not seek treatment. In April 2004, the patient was referred to our department by a local physician w...

OBJECTIVE To assess risk factors for gastroesophageal reflux disease (GERD) in very low birth weight infants with bronchopulmonary dysplasia. METHODS A case-control study was carried out in 23 cases and 23 control subjects with bronchopulmonary dysplasia submitted to 24-hour esophageal pH monitoring between January 2001 and October 2005. Cases and controls were compared for gestational age, b...

OBJECTIVES AND METHODS Impaired blood flow of the upper end of the gastric tube is one of the major causes of anastomotic leak following esophageal reconstruction after esophagectomy for cancer. We applied an additional microvascular anastomosis procedure--the supercharging technique--to improve blood flow. We investigated blood flow improvement in 15 patients who underwent the supercharging te...