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Nasogastric tube as protection for recurrent oesophageal stricture:A case report

World Journal of Gastroenterology 2014年第16期20卷 4806-4810页

作者： Marek Woynarowski maciej d?dalski Violetta Wojno Miko?aj Teisseyre Marek Szymczak Anna Chy?yńska Leszek Hurka?a Emil P?owiecki Jakub Kmiotek department of Gastroenterology Hepatology and Feeding DisordersChildren’s Memorial Health InstituteWarsaw 04-730Poland department of Pediatric Surgery and Organ Transplantation Children’s Memorial Health InstituteWarsaw 04-730Poland Balton Ltd. Warsaw 03-152Poland

This report presents the case of an 8.5-year-old boy with down syndrome after experiencing extensive caustic injury to the oesophagus and stomach resulting from the accidental ingestion of concentrated sulphuric *** patient had undergone 32 unsuccessful endoscopic oesophageal stricture dilatations and stenting procedures performed over a period of 15 mo following the *** reconstruction of the oesophagus was not possible due to previous gastric and cardiac surgeries for congenital *** referring the patient for salivary fistula surgery,the patient received a nasogastric tube with perforations located above the upper margin of the oesophageal stenosis for the passage of saliva and *** tube was well tolerated and improved swallowing;however the backflow of gastric contents caused recurrent infections of the respiratory *** overcome these problems,we developed a double lumen,varying diameter,perforated tube for protection of the oesophageal *** nasogastric tube was found to be safe and decreased the need for hospitalization and further endoscopic *** newly developed tube can thus be considered as a treatment option for patients with recurrent oesophageal stenosis and contraindications for surgical oesophageal reconstruction.

关键词： Corrosive oesophageal stenosis Oesophageal dilatation Oesophageal stenting Nasogastric tube

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Gastrointestinal side effects in children with Wilson's disease treated with zinc sulphate

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World Journal of Gastroenterology 2013年第27期19卷 4356-4362页

作者： Anna Wiernicka Wojciech Jańczyk maciej dαdalski Yesim Avsar Hartmut Schmidt Piotr Socha department of Gastroenterology Hepatology and Malnutritionthe Children's Memorial Health Institute Klinik und Poliklinik für Transplantationsmedizin University Hospital of Muenster

AIM:To investigate the side effects of a zinc sulphate therapy in a cohort of Polish pediatric patients with Wilson's disease. METHOdS:We retrospectively analyzed a cohort of 53 pediatric patients with Wilson's disease treated at the Children's Memorial Health Institute in Warsaw, Poland between the years 1996 and 2011 with zinc sulphate. Patients were diagnosed with Wilson's disease according to the scoring system of Ferenci, with 49 cases confirmed by mutation analysis. data about the dosage scheme of zinc sulphate, side effects and efficacy and toxicity of the treatment were collected and recorded in the patient's medical chart at each visit to the hospital. RESULTS:Mean age of diagnosis for the entire cohort was 10 years (range, 2.5-17 years). duration of treatment with zinc sulfate was 83.3 wk (range, 8-344 wk). Side effects, all of gastrointestinal origin, were observed in 21 patients (40% 9 males and 12 females), irrespective of the duration of therapy. Thirteen out of 21 patients were over the age of 10 years. The most common ATP7B mutation was p.H1069Q. Esophagogastroduodenoscopy, performed in 7 patients (33.3%) suffering from persistent and severe abdominal pain, revealed gastrointestinal ulcerations or erosions with negative Helicobacter pylori tests in all subjects investigated. The above mentioned 7 patients were treated with proton pump inhibitors. Three of those experienced resolution of symptoms, whereas proton-pump inhibitors failed to alleviate symptoms of the remaining four children and conversion of therapy to d-penicillamine was needed. CONCLUSION:Zinc sulphate appears to cause significant gastrointestinal side effects, which children on therapy for Wilson's disease should be closely monitored for.

关键词： Wilson’s disease Zinc Abdominal pain Gastrointestinal ulcer Therapy

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