It appears that the endoscopic approach is the preferable method for the extraction of upper gastrointestinal foreign bodies in child patients because of its high success rate, and that foreign bodies in the small and large intestine tend to be passed spontaneously without complications.

The most common type of esophageal food-related foreign body is the meat bolus, which is frequently associated with underlying esophageal stenosis. Herein, we report two cases of meat bolus impaction associated with nutcracker esophagus. In the first case, the 63-year-old male patient had chest discomfort and swallowing difficulty after ingestion of butcher's meat. In the second case, the 55-year-old male patient had complained of swallowing difficulty after ingestion of chicken. In both cases, no pathologic findings were observed endoscopically after removal of the esophageal meat bolus. We performed esophageal manometry, which showed very high amplitudes of esophageal pressure in the mid- and distal esophagus. These findings were consistent with nutcracker esophagus. These cases show that esophageal motility disorder may be the cause of esophageal foreign body impaction, and esophageal manometry should be performed for evaluation of the cause of foreign body, especially in an endoscopically normal patient.

We describe a case of esophageal perforation that resulted from a fishbone. A 71-year-old man had had a fishbone impacted in the lower esophagus for 2 days. At presentation, the bone was dislodged at endoscopy; one round opening in a deep ulceration was detected when the fishbone was removed. The perforation was closed by endoscopic hemoclipping, after the removal of the fishbone. A thoracic computed tomography revealed air around the esophagus, aorta and bronchus and the presence of a pleural effusion. These findings suggested mediastinal emphysema and mediastinitis due to the esophageal perforation after the removal of the fishbone. Esophagography revealed a focal esophageal defect and linear contrast leakage at the distal esophagus. The mediastinal emphysema and pleural effusion successfully resolved after the endoscopic hemoclip application and conservative management of the perforation.

Thoracic outlet syndrome (TOS) represents a group of heterogeneous and potentially disabling upper-extremity illness that is caused by extrinsic compression of neurovascular structures in the thoraco-cervico-axillary region. Thoracic outlet syndrome can be classified as vascular (arterial and venous) and neurogenic-type. The diagnosis and treatment of TOS remains a challenge for both clinicians and surgeons and when unrecognized or inadequately treated, they can cause chronic pain syndromes, long term restrictions in use of the upper extremities, and limb-threatening complications. The purpose of this study is to briefly review transaxillary approach in the surgery for TOS.

Özet Amaç: Biz bu çalışma ile nonkardiyak göğüs ağrılarının sebeplerini, klinik değerlendirmesini ve tedavi seçeneklerini sunmayı amaçladık. Gereç ve Yöntem: Toplam 40 nonkardiyak göğüs ağrılı hasta değerlendirildi ve tedavi edildi. Olgular öncelikle anjina benzeri göğüs ağrısı ile kardiyoloji kliniğine başvurdular, myokard perfüzyon sintigrafisi ve koroner anjiyografi ile değerlendirildiler ve sonra fizik tedavi, psikiyatri, gastroenteroloji ve göğüs hastalıkları kliniklerine konsülte edildiler. Bulgular: Hastaların yaş ortalaması 41,35 ± 12,20 yıl (18-70 yaş), on iki'si (% 30) erkek, 28'i (% 70) kadın idi. Kas iskelet hastalıkları 9 (%22.5) olgu, emosyonel bozukluk 8 (%20) olgu, özofageal hastalık 14 (% 35) olgu ve göğüs hastalıkları 9 (%22.5) olgu şeklinde tespit edildi. Sonuç: Nonkardiyak göğüs ağrıları klinik uygulamada yaygın, pahalı, zor ve her zaman iyi huylu olmayan bir problemdir. Etyolojik faktörler kas iskelet, emosyonel, özofageal ve göğüs hastalıklarını ilgilendirebilir. Dikkatli değerlendirme, erken tanı ve uygun tedavi yaklaşımı sahip olduğu yüksek maliyet ve hayatı tehdit edici etyolojiler içermesi nedeniyle önemlidir. Anahtar Kelimeler Abstract Aim: We aimed the report the reasons, clinical evaluation, and treatment options of noncardiac chest pain. Material and Method: A total 40 noncardiac chest pain patients had been evaluated and treated. They were applied with angina like chest pain to cardiac clinic firstly, the patients were evaluated with myocard perfusion scintigraphy or coronary angiography, and then all of the patients consulted with musculoskeletal, emotional, esophageal and chest diseases clinics. Results: The mean age of the patients was 41.35±12.20 years (18-70 years), twelve (30%) were male and 28 (70%) were female. Musculoskeletal diseases were observed 9 (22.5%) patients, emotional diseases were observed 8 (20%) patients, esophageal diseases were observed 14 (35%) patients and chest diseases were observed 9 (22.5%) patients. Discussion: Noncardiac Chest Pain is a common, expensive, not always benign and difficult problem in clinical practice. The etiologies should be include musculoskeletal, emotional, esophageal and chest diseases. Carefully evaluation, early diagnosis and appropriate treatment approaches are important because of the high costs and contains the seriously life threating causes.