By George Y. Wu
Textual content describes all the surgical and laparoscopic tactics now used for the gastrointestinal tract. contains transparent, halftone illustrations and discussions of anatomical and physiological adjustments. additionally deals suggestion at the clinical administration of the postsurgical sufferer. For physicians. DNLM: Digestive procedure Surgical Procedures--methods.
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Extra resources for An Internist's Illustrated Guide to Gastrointestinal Surgery (Clinical Gastroenterology)
Nasogastric tubes are not necessary. The patient begins a liquid diet that evening and is discharged the following day. Dysphagia is immediately improved. The postoperative pain, recovery, and return to work are similar to that seen in elective laparoscopic cholecystectomy. 30 Braveman, Khitin, and Brams COMPLICATIONS Complications are uncommon with this procedure. 5% of cases. If identified at the time of surgery, it is easily managed with simple repair of the mucosa. 1%. Early complications occur in approx 5% of cases and include pneumonia, deep venous thrombosis, urinary tract infection, paraesophageal hernia, subphrenic abscess, pleural effusion, esophageal ulcer, and peptic ulcer.
Wu, Khalid Aziz, and Giles F. , Totowa, NJ 23 24 Braveman, Khitin, and Brams of it; the sick Man having taken down meat and drink into his Throat, presently putting this down in the Oesophagus, he did thrust down into the Ventricle, its Orifice being opened, the Food which otherwise would have come back again... (1). This observation made by Thomas Willis in 1674 was the first description of a clinical entity that would later be coined “achalasia” by Sir Arthur Hurst in 1913. Translated from the Greek, achalasia means, “lack of relaxation” and today refers to a disease of the esophagus in which the lower esophageal sphincter fails to relax in the setting of a dilated, aperistaltic, esophageal body.
If the diverticular sac is large, treatment of the muscle alone may not be adequate to relieve the symptoms and the sac itself may need to be addressed either by suspension of excision. Open surgical management of a Zenker’s diverticulum is directed toward elimination of symptoms by transecting the stenotic cricopharyngeus muscle. Variations on the procedure include CP myotomy alone, CP myotomy with resection of the sac, or suspension of the sac. Elderly patients with significant comorbidities who are poor surgical candidates may be able to get relief from the symptoms with cricopharyngeal lysis alone.