scholarly journals Self-Expanding Metal Stent (SEMS) Placement to Treat Bleeding from Late Radiation Esophagitis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Inayat Gill ◽  
Bana Antonios ◽  
Zaid Imam ◽  
Gehad Ghaith
Keyword(s):  
Symptomatic Relief ◽  
Erosive Esophagitis ◽  
Current Treatment ◽  
Metal Stents ◽  
Use Of Self ◽  
Metal Stent ◽  
Sems Placement ◽  
Chronic Radiation ◽  
Esophageal Ulceration ◽  
Radiation Esophagitis

Radiation esophagitis is a serious complication occurring in patients receiving radiotherapy for head and neck cancers. Current treatment with proton pump inhibitors and mucosal protectants provides symptomatic relief with few studies showing improvement in erosive esophagitis or ulceration. Use of self-expandable metal stents (SEMS) in cases of erosive radiation esophagitis refractory to medical therapy has not been studied. We report a case of a patient presenting with recurrent hematemesis from late (chronic) radiation esophagitis with bleeding esophageal ulceration successfully treated with SEMS placement after failure of conservative medical management, proposing a possible utility for SEMS in this setting.

scholarly journals Risk Factors of Duodenobiliary Reflux-Related Dysfunction of Covered Biliary Metal Stents after Treatment of Duodenal Stricture in Patients with Malignant Biliary and Duodenal Obstruction

2021 ◽  
Vol 28 (5) ◽  
pp. 3738-3747
Author(s):  
Chi-Huan Wu ◽  
Mu-Hsien Lee ◽  
Yung-Kuan Tsou ◽  
Cheng-Hui Lin ◽  
Kai-Feng Sung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Biliary Obstruction ◽  
Duodenal Obstruction ◽  
Outlet Obstruction ◽  
Metal Stents ◽  
Papilla Of Vater ◽  
Metal Stent ◽  
Sems Placement ◽  
Duodenal Stricture ◽  
Duodenobiliary Reflux

Duodenal obstruction is often accompanied with unresectable malignant distal biliary obstruction in patients who have undergone biliary self-expandable metal stent (SEMS) placement. Duodenobiliary reflux (DBR) is a major cause of recurrent biliary obstruction (RBO) after covered biliary SEMS placement. We analyzed the risk factors for DBR-related SEMS dysfunction following treatment for malignant duodenal obstruction. Sixty-one patients with covered SEMS who underwent treatment for duodenal obstruction were included. We excluded patients with tumor-related stent dysfunction (n = 6) or metal stent migration (n = 1). Fifty-four patients who underwent covered biliary SEMS placement followed by duodenal metal stenting or surgical gastrojejunostomy were included. Eleven patients had DBR-related biliary SEMS dysfunction after treatment of duodenal obstruction. There was no difference between the duodenal metal stenting group and the surgical gastrojejunostomy group. Duodenal obstruction below the papilla of Vater and a score of ≤2 on the Gastric Outlet Obstruction Scoring System after treatment for duodenal obstruction were associated with DBR-related covered biliary SEMS dysfunction. Thus, creating a reliable route for ensuring good oral intake and avoiding DBR in patients with duodenal obstruction below the papilla of Vater are both important factors in preventing DBR-related covered biliary SEMS dysfunction.

scholarly journals Feasibility and Safety of Endoluminal Radiofrequency Ablation as a Rescue Treatment for Bilateral Metal Stent Obstruction Due to Tumor Ingrowth in the Hilum: A Pilot Study

2021 ◽  
Vol 10 (5) ◽  
pp. 952
Author(s):  
Hoonsub So ◽  
Chi Hyuk Oh ◽  
Tae Jun Song ◽  
Hyun Woo Lee ◽  
Jun Seong Hwang ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Bile Duct ◽  
Adverse Events ◽  
Bile Duct Obstruction ◽  
Metal Stents ◽  
Metal Stent ◽  
Duct Obstruction ◽  
Tumor Ingrowth ◽  
Malignant Bile Duct Obstruction ◽  
Hilar Bile Duct

Background. Radiofrequency ablation (RFA) is a palliative method known for its application in the endoscopic treatment of malignant bile duct obstruction. It may be a useful rescue method for metal stent malfunction caused by tumor ingrowth. This study aimed to examine the feasibility and safety of endoluminal RFA for occluded bilateral hilar metal stents due to tumor ingrowth in patients with malignant hilar bile duct obstruction. Methods: From March 2016 to June 2018, 11 patients with unresectable malignant hilar bile duct stricture with occluded bilateral hilar metal stents due to tumor ingrowth were enrolled. Endoluminal RFA was performed through a novel temperature-controlled catheter at a setting of 7 W power for 120 s with a target temperature of 80 °C via endoscopic retrograde cholangiopancreatography (ERCP). The patients’ demographics, clinical outcomes, and adverse events were investigated. Results: The median age was 64 (interquartile range, 54–72) years. All RFA procedures were successful. Clinical success was achieved in eight patients (72.7%). During the follow-up, eight patients (72.7%) showed stent dysfunction, and the median patency after RFA was 50 days (95% confidence interval (CI): 34–not available (NA)). All stent dysfunctions were successfully managed with ERCP. Ten patients died, and the median overall survival was 289 days (95% CI, 107–NA) from RFA to death. There was one case of mild abdominal pain after the procedure without serious adverse events. Conclusions: As a rescue therapy for occluded bilateral hilar metal stents due to tumor ingrowth, endoluminal RFA seemed to be safe and useful in selected patients.

Main Plant Extracts’ Active Properties Effective on Scopolamine-Induced Memory Loss

2017 ◽  
Vol 32 (7) ◽  
pp. 418-428 ◽  
Author(s):  
Ioana-Miruna Balmus ◽  
Alin Ciobica
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Plant Extracts ◽  
Current Knowledge ◽  
Symptomatic Relief ◽  
Memory Loss ◽  
Current Treatment ◽  
General Effect ◽  
Function Loss ◽  
Theory Research

Alzheimer’s disease leads to progressive cognitive function loss, which may impair both intellectual capacities and psychosocial aspects. Although the current knowledge points to a multifactorial character of Alzheimer’s disease, the most issued pathological hypothesis remains the cholinergic theory. The main animal model used in cholinergic theory research is the scopolamine-induced memory loss model. Although, in some cases, a temporary symptomatic relief can be obtained through targeting the cholinergic or glutamatergic neurotransmitter systems, no current treatment is able to stop or slow cognitive impairment. Many potentially successful therapies are often blocked by the blood–brain barrier since it exhibits permeability only for several classes of active molecules. However, the plant extracts’ active molecules are extremely diverse and heterogeneous regarding the biochemical structure. In this way, many active compounds constituting the recently tested plant extracts may exhibit the same general effect on acetylcholine pathway, but on different molecular ground, which can be successfully used in Alzheimer’s disease adjuvant therapy.

scholarly journals A case of non-contiguous gastric and esophageal iatrogenic perforations managed by self-expanding metal stent placement

2014 ◽  
Vol 05 (02) ◽  
pp. 078-079 ◽  
Author(s):  
Narendra Singh Choudhary ◽  
Rajesh Puri ◽  
Randhir Sud
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Stent Placement ◽  
Gastric Perforation ◽  
Metal Stent ◽  
Sems Placement ◽  
Lower Esophagus ◽  
Iatrogenic Perforation

AbstractWe describe a case of iatrogenic gastric perforation after sleeve gastrectomy procedure as bariatric surgery. Initially, a covered self-expanding metal stent placement (SEMS) was attempted outside, but it resulted in second iatrogenic perforation at lower esophagus. He improved gradually with drainage, antibiotics, and SEMS placement.

scholarly journals Endoskopinis ūminės storosios žarnos obstrukcijos gydymas

2003 ◽  
Vol 1 (1) ◽  
pp. 0-0
Author(s):  
Kęstutis Adamonis ◽  
Dainius Pavalkis ◽  
Žilvinas Saladžinskas ◽  
Algimantas Tamelis
Keyword(s):  
Intestinal Obstruction ◽  
Colonic Obstruction ◽  
Cost Effective ◽  
University Hospital ◽  
Metal Stents ◽  
Metal Stent ◽  
Colorectal Obstruction ◽  
Underlying Malignancy ◽  
Malignant Gastrointestinal Obstruction ◽  
Self Expandable Metal Stent

Kęstutis Adamonis, Dainius Pavalkis, Žilvinas Saladžinskas, Algimantas TamelisKMU Gastroenterologijos klinika, KMU Chirurgijos klinika Šiuolaikis virškinimo trakto piktybinės obstrukcijos gydymas vis labiau tampa minimaliai invazinis. Ligoniai, sergantys storosios žarnos vėžiu, komplikuotu obstrukcija, į gydymo įstaigas patenka skubos tvarka, neretai sunkios būklės, ir nėra idealūs kandidatai chirurginei operacijai. Šiuolaikinėje medicinos literatūroje gausėja mokslinių straipsnių apie sėkmingą ir saugų endoskopiniu būdu įkišamų savaime išsiplečiančių metalinių stentų naudojimą proktologijoje. Nors stentai ir yra brangūs, tačiau proktologinis stentavimas yra rentabili procedūra, leidžianti ligoniams, sergantiems storosios žarnos vėžiu, komplikuotu ūminė storosios žarnos obstrukcija, išvengti neatidėliotinos operacijos, o esant nerezektabiliam vėžiui, – kolostomos. Straipsnyje aprašomas KMU Chirurgijos klinikoje atliktas pirmasis Lietuvoje sėkmingas endoskopinis ūminės žarnų obstrukcijos gydymas stentuojant žarnyną. Prasminiai žodžiai: žarnyno obstrukcija, kolorektinis vėžys, endoskopija, stentavimas. Acute colonic obstruction: endoscopical management Kęstutis Adamonis, Dainius Pavalkis, Žilvinas Saladžinskas, Algimantas Tamelis Management of malignant gastrointestinal obstruction presents a significant challenge. Most patients are in a profoundly decompensated state due to underlying malignancy and are not ideal candidates for invasive surgical procedures. In recent years, self-expandable metal stents have emerged as an effective and safe, less invasive alternative for the treatment of malignant intestinal obstruction. Although stents are expensive, the procedure appears to be cost-effective, since emergency surgery can be avoided in patients with acute bowel obstruction, and in those with advanced disease no resection of the colon is necessary. Here we report a retrospective analysis of a first self-expandable metal stent placed for colorectal obstruction at Kaunas Medical University Hospital, as well as review the literature published on self-expandable metal stent placement. Our first data confirm self-expandable metal stent efficacy in palliation of malignant intestinal obstruction. Keywords: intestinal obstruction, colorectal cancer, endoscopy, endoluminal stenting.

Use of self-expanding metal stents for difficult variceal bleed

2017 ◽  
Vol 36 (6) ◽  
pp. 468-473
Author(s):  
M. K. Goenka ◽  
Usha Goenka ◽  
I. K. Tiwary ◽  
Vijay Rai
Keyword(s):  
Metal Stents ◽  
Use Of Self ◽  
Variceal Bleed ◽  
Self Expanding Metal Stents
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