0000000000280636
AUTHOR
R. Grüßner
A modified prosthesis for the treatment of malignant esophagotracheal fistula
Esophagotracheal fistula is usually a sequela of irradiation or laser treatment of advanced carcinoma of the esophagus or the tracheobronchial tree. Resection of the tumor in these cases is not possible, and palliative bypass surgery is highly risky. The peroral placement of a prosthesis is less invasive, but conventional prostheses often fail to occlude the fistula. The authors regularly use an endoscopic multiple-diameter bougie for dilation. After dilation, a specially designed prosthesis is pushed through the tumor stenosis to block the fistula. This procedure can be done without general anesthesia. The funnels of conventional prostheses cannot cover the fistula when there is either a w…
Significance of ultrasound for the diagnosis of hypertrophic pyloric stenosis
The sonographic features of hypertrophic pyloric stenosis (HPS) were evaluated in a 5-year prospective study (1981–1985) at the University Clinic of Pediatric Surgery in Mainz. In 37 cases real-time ultrasound was performed preoperatively to measure muscle thickness, diameter, and length of the pylorus; the recorded values were compared with those of a control group. Muscular wall thickness proved to be the most reliable parameter, while pyloric canal length was the most difficult measurement to obtain. Diameter alone was not adequate to establish the sonographic diagnosis, which depends on the individually and functionally different luminal width and submucosal thickness. Significant sonog…