Twisting of sleeve gastrectomy: two ways of clinic presentation.

We present two cases of patients who underwent laparoscopic sleeve gastrectomy and who were subsequently diagnosed with gastric twisting. Both cases required conversion to laparoscopic gastric bypass. Accompanying symptoms may vary but they commonly include early satiety, epigastric pain associated with food intake, gastroesophageal reflux and early vomiting. Although diagnose is mainly clinical, it requires high suspicion since endoscopy and gastrointestinal studies are not conclusive. The principal therapeutic options are endoscopic dilatations, serotomy and conversion to gastric bypass. PMID: 31755282 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research

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AbstractPurpose of reviewHigh resolution esophageal manometry (HRM) has expanded understanding of esophageal motor function. The Chicago Classification scheme has allowed systematic categorization of the myriad of manometric parameters identified during HRM. Multichannel intraluminal impedance pH has enhanced ambulatory reflux monitoring through complete assessment of esophageal content transit. However, the clinical implications of identified minor esophageal functional disorders remain unclear.Recent findingsEsophagogastric junction outlet obstruction is defined by esophagogastric junction obstruction with preserved peri...
Source: Current Treatment Options in Gastroenterology - Category: Gastroenterology Source Type: research
By HANS DUVEFELT, MD Many patients make this or similar requests, especially in January it seems. This phenomenon has its roots in two things. The first is the common misconception that random blood test abnormalities are more likely early warning signs of disease than statistical or biochemical aberrances and false alarms. The other is the perverse policy of many insurance companies to cover physicals and screening tests with zero copay but to apply deductibles and copays for people who need tests or services because they are sick. It is crazy to financially penalize a person with chest pain for going to the ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Education Medical Practice Physicians Primary Care blood tests Hans Duvefelt Labs Source Type: blogs
A former resident texted me this ECG, done for epigastric pain in an 18 year old.  The pain resolved immediately with treatment for acid reflux, and in the clinician's opinion was clearly GI in origin, but he wanted to know what the strange waves in the QRS were:See the unusual notching in II, III, aVF, and V2-V4.I had no idea what they were.  They reminded me of theDelayed Activation Wave associated with circumflex acute MI.See this case: https://hqmeded-ecg.blogspot.com/2018/05/is-there-delayed-activation-wave.html.But they are clearly different from this.I put it on Facebook EKG club and this is the ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Abstract CASE PRESENTATION: A 64-year-old man presented for consideration for lung transplant. He had a history of previous tobacco use, OSA on CPAP therapy, and gastroesophageal reflux disease. He worked as a design engineer. The patient had a 4-year history of dyspnea on exertion, followed with periodic CT scan of the chest. Nine months prior to his evaluation for lung transplant, the patient developed worsening of dyspnea, dry cough, poor appetite, and weight loss. At times, the cough was violent and associated with chest pressure. He was prescribed systemic corticosteroids and antibiotics without improvement. ...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
A few studies have shown that esophageal air events (EAEs), such as air-swallows, may be associated with symptoms that have historically been associated with gastroesophageal reflux disease (GERD). To objectively test a hypothesis that all EAE types (air-swallows, supragastric belches and gastric belches) can be associated with GERD-like symptoms, we removed the impedance “tags” from the GER episodes (placed during autoscan) and instead tagged either air-swallows, supragastric belches or gastric belches in each of 3 copies of the 24-hour impedance tracing for 2 infant patients who presented with symptoms sugges...
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Short Communication: Gastroenterology Source Type: research
In the early 1990s, doctors began describing a new condition affecting the esophagus of patients who were predisposed to allergies including food allergy, asthma, and eczema, and who were having trouble swallowing. Today, we call this condition eosinophilic esophagitis (EoE). What is EoE? EoE is an allergic inflammation of the esophagus that causes a range of symptoms. Adolescents and adults most often experience it as difficulty swallowing, sometimes feeling like food moves too slowly through the esophagus and into the stomach. In some cases, food actually gets stuck (and may require urgent removal). Children and some adu...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Allergies Digestive Disorders Health Source Type: blogs
Infants with cleft palate or cleft lip and palate (CP/CLP) have specific feeding needs based upon unique anatomy and swallow physiology. Poor or absent inner oral pressure and compensatory muscle movements affect all phases—oral, pharyngeal, and esophageal—of swallowing, and in some cases, increase risk of aspiration. These babies expend a significant amount of energy in the act of feeding. They demonstrate an average rate of 109.26 sucks per minute compared to infants without clefts who averaged 75.07 sucks per minute. Increased energy expenditure might lead to fatigue. Under these conditions, infants experien...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Health Care Private Practice Slider Speech-Language Pathology Dysphagia Early Intervention Feeding Disorders Swallowing Disorders Source Type: blogs
  The original Wheat Belly book rocked the nutritional world with its revolutionary ideas. But, as time has passed, I’ve added new strategies and concepts that have expanded the overall program and taken the health, weight, and youth-preserving benefits even further. I have therefore collected all this new material into a new Revised &Expanded Edition. The new Revised &Expanded Edition of Wheat Belly is now available at all major bookstores. Here is a brief excerpt from the new foreword: Wheat Belly began as my modest effort to help people with heart disease stop relying on the revolving door of angiopla...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Open autoimmune blood sugar bowel flora cholesterol diabetes Dr. Davis Gliadin gluten-free grain-free grains Inflammation low-carb microbiota prebiotic probiotic wheat belly Source Type: blogs
Authors: Mohamed AA, Lu XL, Mounmin FA Abstract Esophageal candidiasis (EC) is the most common type of infectious esophagitis. In the gastrointestinal tract, the esophagus is the second most susceptible to candida infection, only after the oropharynx. Immunocompromised patients are most at risk, including patients with HIV/AIDS, leukemia, diabetics, and those who are receiving corticosteroids, radiation, and chemotherapy. Another group includes those who used antibiotics frequently and those who have esophageal motility disorder (cardiac achalasia and scleroderma). Patients complained of pain on swallowing, difficu...
Source: Canadian Journal of Gastroenterology - Category: Gastroenterology Tags: Can J Gastroenterol Hepatol Source Type: research
CONCLUSIONS: In patients with reflux-related symptoms, with or without esophagitis, the water load test is frequently abnormal, suggesting an altered gastric function. Nissen fundoplication is associated with a relatively higher incidence of bloating, epigastric pain and fullness. These preliminary data could explain the incomplete resolution of symptoms after surgery in some patients, and suggest the use of additional studies to explore the gastric function in pre-surgical evaluation. PMID: 31760736 [PubMed - as supplied by publisher]
Source: Minerva Gastroenterologica e Dietologica - Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research
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