By George Y. Wu
Few scientific disciplines were reworked so dramatically via developments in technological know-how and know-how as gastrointestinal surgical procedure. first of all, sleek ph- macology has almost eradicated a few sorts of surgical procedure altogether. If one have been to take a peek at a regular working room agenda in a hectic medical institution of the Sixties, gastrectomies of 1 sort or one other could have constituted a wide block of the most important surgical procedures. the arrival of potent H2-histamine receptor antagonists and, extra + + lately, the H ,K -ATPase (proton pump) inhibitors resulted in a precipitous decline in these techniques such that they're not often played at the present time. fascinating new methods to treating inflammatory bowel ailments and their complications―such as fistulas― with anticytokine treatment could someday have a equally profound impact on surgical procedure for this situation in addition. past pharmaceutics, advances in imaging concepts have enormously facilitated the identity and characterization of pathology within the gastrointestinal tract in a manner that might were incredible just a couple of years in the past. simply to visualize the pancreas indirectly used to be a horrendous job until eventually belly ultrasound, magnetic resonance imaging, or machine tomography made it easy. the truth that the intestine is a hole organ that may be accessed throughout the mouth, anus, or maybe throughout the wall of the stomach has been absolutely exploited with fiberoptic endoscopes which may bend round corners comfortably and allow surgical procedure to be performed via them.
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Extra info for An Internist’s Illustrated Guide to Gastrointestinal Surgery (Clinical Gastroenterology)
2. Dysphagia and regurgitation with eventual weight loss are usual presenting complaints. 3. The diagnosis may be made with a barium swallow, but should be followed with upper endoscopy and manometric studies. 4. Laparoscopic Heller myotomy with partial fundoplication is the optimal treatment for patients with acceptable surgical risk. Ninety percent of patients report excellent results with this minimally invasive procedure. Chapter 3 / Esophagectomy for Achalasia 31 5. Pneumatic dilation and botulinum toxin injection are alternatives for patients who have unacceptable surgical risk factors.
Tumors of the hypopharynx, larynx, and esophagus may present with a similar spectrum of symptoms. Careful history-taking regarding the exact nature of symptoms, associated symptoms, comorbid conditions, and risk factors for carcinoma are vital. A thorough examination including indirect visualization of the oropharynx, hypopharynx, and larynx is needed to evaluate anatomy, as well as pathology. Pooling of secretions may be noted in the postcricoid region. A subtle fullness of the neck may be appreciated on palpation.
Comparison of endoscopic diathermy and resection in the surgical management of pharyngeal diverticula. J Laryngol Otol 1985;99:179–182. Chapter 3 / Esophagectomy for Achalasia 3 23 Esophagectomy for Achalasia Laparoscopic Heller Myotomy and Dor Fundoplication Joshua M. Braveman, MD, Lev Khitin, MD, and David M. Brams, MD CONTENTS INTRODUCTION EPIDEMIOLOGY PATHOPHYSIOLOGY ETIOLOGY CLINICAL FEATURES PATIENT EVALUATION TREATMENT OPTIONS SURGICAL MANAGEMENT INDICATIONS CONTRAINDICATIONS SURGICAL TECHNIQUE COMPLICATIONS COST OF PROCEDURE RESULTS OF HELLER MYOTOMY SUMMARY REFERENCES INTRODUCTION At length the Disease having overcome all remedies, he was brought into that condition, that growing hungry he would eat until Oesophagus was filled up to the Throat, in the mean time nothing sliding down into the Ventricle, he cast up raw (or crude) whatsoever he had taken in: when that no Medicines could help and he languished away for hunger, and every Day was in Danger of Death.