scholarly journals Esophageal Pemphigus Vulgaris: A Rare Etiology of Upper Gastrointestinal Hemorrhage

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Jennifer Rose F. Del Castillo ◽  
Muhammad Nadeem Yousaf ◽  
Fizah S. Chaudhary ◽  
Nahar Saleh ◽  
Lawrence Mills
Keyword(s):  
Early Recognition ◽  
Gastrointestinal Symptoms ◽  
Pemphigus Vulgaris ◽  
Diagnostic Endoscopy ◽  
Presenting Symptoms ◽  
Esophageal Involvement ◽  
Asymptomatic Patients ◽  
Mucosal Surfaces ◽  
Early Endoscopy ◽  
Upper Gastrointestinal

Pemphigus vulgaris (PV) is an autoimmune blistering disorder of the skin and mucosal surfaces characterized by acantholysis (loss of adhesion between epidermal cells). Esophageal involvement of PV is an underdiagnosed entity as routine diagnostic endoscopy is not recommended in asymptomatic patients. Dysphagia and odynophagia are common presenting symptoms; however, upper gastrointestinal bleeding (UGIB) associated with esophageal involvement of PV without a history of mucosal blistering is extremely uncommon. We present a case of esophageal involvement of PV associated with active UGIB that was diagnosed on endoscopic evaluation. This case illustrated the importance of early endoscopy to identify the esophageal involvement of PV especially in patients with preexisting disease who present with gastrointestinal symptoms such as dysphagia, odynophagia, and hematemesis. Early recognition of esophageal involvement of PV and initiation of corticosteroid and/or immunosuppressant therapy may improve the outcome of the disease.

scholarly journals Esophageal Involvement of Pemphigus Vulgaris

2020 ◽  
pp. 1-3
Author(s):  
Vedat Goral ◽  
Vedat Goral ◽  
Ali Balevi ◽  
Sevilay Aligulu ◽  
Rukiye Nilgun Erdogan
Keyword(s):  
Female Patient ◽  
Pemphigus Vulgaris ◽  
Presenting Symptoms ◽  
Esophageal Involvement ◽  
Life Threatening

Pemphigus is an autoimmune and life-threatening disease. Esophageal involvement of pemphigus vulgaris is rare. The most common presenting symptoms are odynophagia and dysphagia. Here, I present one cases of pemphigus vulgaris presenting with dysphagia because of esophageal involvement of the disease. In case, a 27-year-old female patient with a prior diagnosis of pemphigus vulgaris presented with dysphagia. Esophagogastroduodenoscopy showed diffuse mucosal exfoliation and oozing bleeding of the esophagus. The patient recovered after the administration of corticosteroids, pantoprazole and azathioprurine.

scholarly journals Esophageal Involvement of Pemphigus Vulgaris Associated with Upper Gastrointestinal Bleeding

2014 ◽  
Vol 47 (5) ◽  
pp. 452 ◽  
Author(s):  
Sooyun Chang ◽  
Soo Jung Park ◽  
Sun Wook Kim ◽  
Moo-Nyun Jin ◽  
Jung-Hee Lee ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Pemphigus Vulgaris ◽  
Esophageal Involvement ◽  
Upper Gastrointestinal

scholarly journals Role of Endoscopy in the Investigation of Upper Gastrointestinal Symptoms in HIV-Infected Patients

1999 ◽  
Vol 13 (4) ◽  
pp. 305-310 ◽  
Author(s):  
C Mel Wilcox
Keyword(s):  
Gastrointestinal Symptoms ◽  
High Yield ◽  
Severe Diarrhea ◽  
Presenting Symptoms ◽  
Upper Gastrointestinal Symptoms ◽  
Empirical Antifungal Therapy ◽  
Cd4 Lymphocyte ◽  
Immunodeficiency Syndrome ◽  
Diagnostic Benefit ◽  
Upper Gastrointestinal

Endoscopy plays a pivotal role in the management of patients with the acquired immunodeficiency syndrome (AIDS), because tissue documentation of opportunistic processes is often necessary to establish a definitive diagnosis. With progression of immunodeficiency, endoscopy becomes more important because the predisposition to opportunistic disorders of the gastrointestinal tract is greatly increased. The yield of upper endoscopy in human immunodeficiency virus (HIV)-infected patients is dependent upon the indication for the procedure, including the clinical presentation and the stage of immunodeficiency. Indications for which endoscopy has a high yield include AIDS with esophageal symptoms refractory to empirical antifungal therapy, small bowel biopsy for chronic severe diarrhea and upper gastrointestinal bleeding. Although processes can be identified, a diagnosis is less likely in patients who present with nausea and vomiting or nonspecific abdominal pain. By tailoring the use of endoscopy to the presenting symptoms and CD4 lymphocyte count, the diagnostic benefit can be increased.

scholarly journals Trans-hiatal herniation following esophagectomy or gastrectomy: retrospective single-center experiences with a potential surgical emergency

Hernia ◽  
2021 ◽  
Author(s):  
P. U. Oppelt ◽  
I. Askevold ◽  
R. Hörbelt ◽  
F. C. Roller ◽  
W. Padberg ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Hiatal Hernia ◽  
Surgical Repair ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Gastric Surgery ◽  
Hiatal Hernia Repair ◽  
Single Center ◽  
Asymptomatic Patients

Abstract Purpose Trans-hiatal herniation after esophago-gastric surgery is a potentially severe complication due to the risk of bowel incarceration and cardiac or respiratory complaints. However, measures for prevention and treatment options are based on a single surgeon´s experiences and small case series in the literature. Methods Retrospective single-center analysis on patients who underwent surgical repair of trans-hiatal hernia following gastrectomy or esophagectomy from 01/2003 to 07/2020 regarding clinical symptoms, hernia characteristics, pre-operative imaging, hernia repair technique and perioperative outcome. Results Trans-hiatal hernia repair was performed in 9 patients following abdomino-thoracic esophagectomy (40.9%), in 8 patients following trans-hiatal esophagectomy (36.4%) and in 5 patients following conventional gastrectomy (22.7%). Gastrointestinal symptoms with bowel obstruction and pain were mostly prevalent (63.6 and 59.1%, respectively), two patients were asymptomatic. Transverse colon (54.5%) and small intestine (77.3%) most frequently prolapsed into the left chest after esophagectomy (88.2%) and into the dorsal mediastinum after gastrectomy (60.0%). Half of the patients had signs of incarceration in pre-operative imaging, 10 patients underwent emergency surgery. However, bowel resection was only necessary in one patient. Hernia repair was performed by suture cruroplasty without (n = 12) or with mesh reinforcement (n = 5) or tension-free mesh interposition (n = 5). Postoperative pleural complications were most frequently observed, especially in patients who underwent any kind of mesh repair. Three patients developed recurrency, of whom two underwent again surgical repair. Conclusion Trans-hiatal herniation after esophago-gastric surgery is rare but relevant. The role of surgical repair in asymptomatic patients is disputed. However, early hernia repair prevents patients from severe complications. Measures for prevention and adequate closure techniques are not yet defined.

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