Esophageal Food Bolus Obstruction
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Esophageal Food Bolus Obstruction
An esophageal food bolus obstruction is a medical emergency caused by the obstruction of the esophagus by an ingested foreign body. It is usually associated with diseases that may narrow the lumen of the esophagus, such as eosinophilic esophagitis, Schatzki rings, peptic strictures, webs, or cancers of the esophagus; rarely it can be seen in disorders of the movement of the esophagus, such as nutcracker esophagus. While some esophageal food boli can pass by themselves or with the assistance of medications, some require the use of endoscopy to push the obstructing food into the stomach, or remove it from the esophagus. The use of glucagon, while common, has not been found to be useful. Eponymous names include 'the steakhouse syndrome' and 'backyard barbeque syndrome'. Signs and symptoms Many foods can lodge themselves in the esophagus, but the most common are meats such as steak, poultry, or pork leading to the colourful description of the phenomenon as steakhouse syndrome. Pe ...
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Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) is an allergic inflammatory condition of the esophagus that involves eosinophils, a type of white blood cell. In healthy individuals, the esophagus is typically devoid of eosinophils. In EoE, eosinophils migrate to the esophagus in large numbers. When a trigger food is eaten, the eosinophils contribute to tissue damage and inflammation. Symptoms include swallowing difficulty, food impaction, vomiting, and heartburn. Eosinophilic esophagitis was first described in children but also occurs in adults. The condition is not well understood, but food allergy may play a significant role. The treatment may consist of removal of known or suspected triggers and medication to suppress the immune response. In severe cases, it may be necessary to enlarge the esophagus with an endoscopy procedure. While knowledge about EoE has been increasing rapidly, diagnosis of EoE can be challenging because the symptoms and histo-pathologic findings are not specific. E ...
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Dysphagia
Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a disease#Terminology, condition in its own right. It may be a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach, a lack of Pharynx, pharyngeal sensation or various other inadequacies of the swallowing mechanism. Dysphagia is distinguished from other symptoms including odynophagia, which is defined as painful swallowing, and Globus Pharyngis, globus, which is the sensation of a lump in the throat. A person can have dysphagia without odynophagia (dysfunction without pain), odynophagia without dysphagia (pain without dysfunction) or both together. A psychogenic disease, psychogenic dysphagia is known as phagophobia. Classification Dysphagia is classified into the following major types: # Oropharyngeal dysphagia # Esophageal dysphagia, Esophageal and obstructive dysphagia # Neuromuscular symptom comp ...
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Hyoscine Butylbromide
Hyoscine butylbromide, also known as scopolamine butylbromide and sold under the brandname Buscopan among others, is an anticholinergic medication used to treat crampy abdominal pain, esophageal spasms, renal colic, and bladder spasms. It is also used to improve respiratory secretions at the end of life. Hyoscine butylbromide can be taken by mouth, injection into a muscle, or into a vein. Side effects may include sleepiness, vision changes, dry mouth, rapid heart rate, triggering of glaucoma, and severe allergies. Sleepiness is uncommon. It is unclear if it is safe in pregnancy. It appears safe in breastfeeding. Greater care is recommended in those with heart problems. It is an anticholinergic agent, which does not have much effect on the brain. Hyoscine butylbromide was patented in 1950, and approved for medical use in 1951. It is on the World Health Organization's List of Essential Medicines. It is not available in the United States, and a similar compound methscopola ...
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Coca-Cola
Coca-Cola, or Coke, is a carbonated soft drink manufactured by the Coca-Cola Company. Originally marketed as a temperance drink and intended as a patent medicine, it was invented in the late 19th century by John Stith Pemberton in Atlanta, Georgia. In 1888, Pemberton sold Coca-Cola's ownership rights to Asa Griggs Candler, a businessman, whose marketing tactics led Coca-Cola to its dominance of the global soft-drink market throughout the 20th and 21st century. The drink's name refers to two of its original ingredients: coca leaves and kola nuts (a source of caffeine). The current formula of Coca-Cola remains a closely guarded trade secret; however, a variety of reported recipes and experimental recreations have been published. The secrecy around the formula has been used by Coca-Cola in its marketing as only a handful of anonymous employees know the formula. The drink has inspired imitators and created a whole classification of soft drink: colas. The Coca-Cola Company p ...
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Self-expandable Metallic Stent
A self-expandable metallic stent (or SEMS) is a metallic tube, or stent that holds open a structure in the gastrointestinal tract to allow the passage of food, chyme, feces, stool, or other secretions related to digestion. Surgeons insert SEMS by endoscopy, inserting a fiber optics, fibre optic camera—either through the mouth or colon (anatomy), colon—to reach an area of narrowing. As such, it is termed an ''endoprosthesis''. SEMS can also be inserted using fluoroscopy where the surgeon uses an X-ray image to guide insertion, or as an adjunct to endoscopy. The vast majority of SEMS are used to alleviate symptoms caused by cancers of the gastrointestinal tract that obstruct the interior of the tube-like (or luminal) structures of the bowel — namely the esophagus, duodenum, common bile duct and colon. SEMS are designed to be permanent and, as a result, are often used when the cancer is at an advanced stage and cannot be removed by surgery. Composition and structure Self-expan ...
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Esophageal Atresia
Esophageal can refer to: * The esophagus * Esophageal arteries * Esophageal glands The esophageal glands are glands that are part of the digestive system of various animals, including humans. In humans Esophageal glands in humans are a part of a human digestive system. They are a small compound racemose exocrine glands of the m ... * Esophageal cancer {{disambig ...
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Tracheoesophageal Fistula
A tracheoesophageal fistula (TEF, or TOF; see spelling differences) is an abnormal connection (fistula) between the esophagus and the trachea. TEF is a common congenital abnormality, but when occurring late in life is usually the sequela of surgical procedures such as a laryngectomy. Presentation Tracheoesophageal fistula is suggested in a newborn by copious salivation associated with choking, coughing, vomiting, and cyanosis coincident with the onset of feeding. Esophageal atresia and the subsequent inability to swallow typically cause polyhydramnios in utero. Rarely it may present in an adult. Complications Surgical repair can sometimes result in complications, including: * Stricture, due to gastric acid erosion of the shortened esophagus * Leak of contents at the point of anastomosis * Recurrence of fistula * Gastro-esophageal reflux disease * Dysphagia * Asthma-like symptoms, such as persistent coughing/wheezing * Recurrent chest infections * Tracheomalacia Associations ...
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Esophageal Web
Esophageal webs are thin membranes occurring anywhere along the esophagus. Presentation Its main symptoms are pain and difficulty in swallowing (dysphagia). Esophageal webs are thin membranes of normal esophageal tissue consisting of mucosa and submucosa that can partially protrude/obstruct the esophagus. They can be congenital or acquired. Congenital webs commonly appear in the middle and inferior third of the esophagus, and they are more likely to be circumferential with a central or eccentric orifice. Acquired webs are much more common than congenital webs and typically appear in the cervical area (postcricoid). Clinical symptoms of this condition are selective (solid more than liquids) dysphagia, thoracic pain, nasopharyngeal reflux, aspiration, perforation and food impaction (the last two are very rare). file:Zervikales Web.jpg, Esophageal web stenosis in barium swallow examination lateral view. file:Web mit Jet-Phaenomen.jpg, Web with "jet-phenomenon". Arrowhead on inco ...
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Mucosa
A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is mostly of endodermal origin and is continuous with the skin at body openings such as the eyes, eyelids, ears, inside the nose, inside the mouth, lips, the genital areas, the urethral opening and the anus. Some mucous membranes secrete mucus, a thick protective fluid. The function of the membrane is to stop pathogens and dirt from entering the body and to prevent bodily tissues from becoming dehydrated. Structure The mucosa is composed of one or more layers of epithelial cells that secrete mucus, and an underlying lamina propria of loose connective tissue. The type of cells and type of mucus secreted vary from organ to organ and each can differ along a given tract. Mucous membranes line the digestive, respiratory and reproductive trac ...
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Schatzki Ring 2
Richard Schatzki (1901–1992) was a German-American radiologist. He was born in Klafeld, Germany on February 22, 1901. In 1933, Nazi leadership declared that no one of Jewish background could hold a position in German governmental facilities. As a result, Schatzki was forced to leave his University Hospital position. Four months later, Schatzki moved to America with his wife Greta and young son Stefan. They were the first Schatzkis to leave Germany, although other family members would join them in America in the years leading up to the war as conditions in Germany deteriorated further. Upon leaving his home nation, Germany, his wife was pregnant with their second son. After arriving in the United States, George Schatzki came into the world. He trained in radiology in Berlin with Hans Heinrich Berg (1889-1968) who was the leading diagnostic radiologist in Germany at that time. He immigrated to the United States in 1933 and worked as a radiologist physician in Boston at MGH until 194 ...
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Aspiration Pneumonia
Aspiration pneumonia is a type of lung infection that is due to a relatively large amount of material from the stomach or mouth entering the lungs. Signs and symptoms often include fever and cough of relatively rapid onset. Complications may include lung abscess, acute respiratory distress syndrome, empyema, and parapneumonic effusion. Some include chemical induced inflammation of the lungs as a subtype, which occurs from acidic but non-infectious stomach contents entering the lungs. Infection can be due to a variety of bacteria. Risk factors include decreased level of consciousness, problems with swallowing, alcoholism, tube feeding, and poor oral health. Diagnosis is typically based on the presenting history, symptoms, chest X-ray, and sputum culture. Differentiating from other types of pneumonia may be difficult. Treatment is typically with antibiotics such as clindamycin, meropenem, ampicillin/sulbactam, or moxifloxacin. For those with only chemical pneumonitis, antibio ...
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Esophageal Perforation
Esophageal rupture is a rupture of the esophagus, esophageal wall. Iatrogenic causes account for approximately 56% of esophageal perforations, usually due to medical instrumentation such as an endoscopy or paraesophageal surgery. In contrast, the term Boerhaave syndrome is reserved for the 10% of esophageal perforations which occur due to vomiting. Spontaneous perforation of the esophagus most commonly results from a full-thickness tear in the esophageal wall due to a sudden increase in intraesophageal pressure combined with relatively negative intrathoracic pressure caused by straining or vomiting (effort rupture of the esophagus or Boerhaave's syndrome). Other causes of spontaneous perforation include caustic ingestion, esophagitis, pill esophagitis, Barrett's esophagus, infectious ulcers in patients with HIV/AIDS, AIDS, and following dilation of esophageal strictures. In most cases of Boerhaave's syndrome, the tear occurs at the left postero-lateral aspect of the distal esophag ...
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