The detection of two early, asymptomatic oesophageal adenocarcinomas in a high risk patient group justifies our policy of routine upper GI endoscopy prior to gastric banding surgery.
The incidence of gastric ulcer in hiatal hernia is highest in para-esophageal hernia and in chronic incarcerated hernia in older patients. Two patients with chronic incarcerated sliding hernias complicated by unrecognized gastric ulceration and perforation are described. One patient developed a subhepatic and mediastinal abscess; the other developed a gastropleural fistula. The incidence, clinical and roentgen findings, complications, and treatment of gastric ulcers in hiatal hernia are discussed.
The patient was a 60-year-old white male who, for 18 months, had complained of a substernal wheeze on exertion, exertional dyspnoea and cough, and attacks of acute respiratory distress. There was no haemoptysis or dyshpagia and he was treated for bronchial asthma until bronchoscopy revealed the tumour which had not been recognized in plain chest films. He showed no evidence of a neurofibromatosis and apart from reduction in pulmonary function tests on a PO2 of 74, his laboratory tests were negative. There was no family history of neurofibromatosis. He underwent thoracotomy and a smooth rounded pedunculated tumour, 2.5 cm in diameter, arising from the posterior wall of the trachea, 3 cm above the carina was excised. He has had no tumour recurrence.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.