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Novel use of esophageal overtube and water flushes as a safety indicator and facilitator for the push technique in esophageal food impaction

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Discussion of Clinical Cases 2020年第1期7卷 8-11页

作者： Paul P Shao Jasleen K Grewal adam m custer VA Greater Los Angeles Healthcare System UCLA David Geffen School of MedicineUSA

Esophageal food impaction requires urgent endoscopic intervention either by extraction or pushing into the *** to risks of perforation,controversy exists between when to extract verses when to push the food *** are no clear guidelines on when it is safe to push a food bolus;endoscopists rely on their subjective experiences and *** present a case with a novel use of an esophageal overtube and water flushes to determine the safety of pushing a food bolus and facilitate passage into the stomach.

关键词： Esophageal food impaction Esophageal foreign body EGD Dysphagia EGD push technique

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负压引流术:一种治疗巨大脐疝的新方法

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世界核心医学期刊文摘（儿科学分册） 2006年第5期2卷 40-41页

作者： Kilbride K.E. Cooney D.R. custer m.D. 刘凯 Children's Surgery Children's Hospital Scott and White Hospital Temple TX 76502 United States

Introduction: Closure of giant omphalocele can present a surgical challenge. Neither silo, skin flap, nor primary closure has been successful in treating all patients. We present a novel application of the vacuum-assisted closure (VAC) device, which allows for improved results in these difficult cases. methods: The VAC device (KCI, San Antonio, Tex) consisted of a sponge applied directly to the bowel and liver, covered with impermeable transparent dressing, and attached to a low negative pressure system. The sponge was changed every 3 to 5 days under local sedation. Patients: All 3 patients had giant omphaloceles. The first infant, a 34 week gestational age (WGA) male, was initially treated with silo reduction, which disrupted after 21 days. The large mass of bowel and liver made primar y closure impossible. The VAC was applied for 45 days. The viscera was easily reduced and subsequently covered with acellular dermal matrix (AlloDerm). The VAC was reapplied, and the small remaining defect was skin-grafted. The second male infant was a 34 WGA male infant who became septic after failure of prosthetic mesh closure. The VAC was applied for 22 days after removal of the mesh. The infection resolved, and the defect size was reduced, allowing for skin flap closure. mesh infection and development of an enterocutaneous fistula in the last patient, a 37 WGA female child, were treated by mesh removal and application of the VAC for 36 days. The VAC allowed for control of the fistula output and development of a healthy granulation bed. Results: Vacuum-assisted closure was associated with (1) rapid shrinkage and reduction of the viscera (22-45 days); (2) cleansing of the wound; (3) excellent granulation; (4) maintenance of a sterile environment; and (5) ease of use, with changes possible at the bedside. Conclusion: The VAC device should be considered a safe and effective alternative in treating complicated cases of giant omphalocele until a more definitive closure method can be us

关键词：负压引流术脐疝治疗负压吸引装置透明敷料研究对象海绵

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与先天性巨结肠(全结肠无神经节细胞症)并发的回肠闭锁

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世界核心医学期刊文摘（儿科学分册） 2006年第2期2卷 52-52页

作者： Gupta m. Beeram m.R. Pohl J.F. custer m.D. 平智广 Division of Pediatric Gastroenterology Scott and White Memorial Hospital Texas A and M University System Health Science Center Temple TX 76508 United States

One of the most common causes of small bowel obstruction in newborns is ileal atresia, and one of the most common causes of colonic obstruction in neonates is aganglionic megacolon (Hirschsprung disease). However, atresias of the small intestinal tract associated with Hirschsprung disease are extremely rare. We describe an infant born with both ileal atresia and Hirschsprung disease. This is the 19th known report of the case of an infant who had ileal atresia associated with Hirschsprung disease.

关键词：先天性巨结肠全结肠无神经节细胞症回肠闭锁并发无神经节细胞性巨结肠新生儿小肠梗阻大肠梗阻小肠闭锁

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