By George Wu

Few medical disciplines were remodeled so dramatically via developments in technology and know-how as gastrointestinal surgical procedure. first of all, glossy ph- macology has nearly eradicated a few forms of surgical procedure altogether. If one have been to take a peek at a standard working room time table in a hectic sanatorium of the Nineteen Sixties, gastrectomies of 1 sort or one other may have constituted a wide block of the main surgical procedures. the arrival of potent H2-histamine receptor antagonists and, extra + + lately, the H ,K -ATPase (proton pump) inhibitors ended in a precipitous decline in these systems such that they're infrequently played this present day. intriguing new ways to treating inflammatory bowel ailments and their complications—such as fistulas— with anticytokine treatment may possibly someday have a equally profound influence on surgical procedure for this situation besides. past pharmaceutics, advances in imaging ideas have tremendously facilitated the id and characterization of pathology within the gastrointestinal tract in a manner that will were unbelievable just a couple of years in the past. simply to visualize the pancreas ultimately used to be a horrendous activity until eventually belly ultrasound, magnetic resonance imaging, or machine tomography made it easy. the truth that the intestine is a hole organ that may be accessed throughout the mouth, anus, or maybe throughout the wall of the stomach has been totally exploited with fiberoptic endoscopes that could bend round corners comfortably and allow surgical procedure to be carried out via them.

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Additional resources for An Internist's Illustrated Guide to Gastrointestinal Surgery

Sample text

The procedure is now often referred to as the Dohlman procedure. The procedure has the advantages of no external incisions, generally shorter OR time, as well as generally shorter recovery time. The procedure does require general anesthesia and does have its own set of complications associated with it. Results of the Dohlman procedure in his series were excellent. They reported 90% improvement, and only a 7% incidence of residual sac. In this series, the esophagus and the party wall were divided by electrocautery.

Patients often present with a longstanding history of gradually increasing dysphagia of both solids and liquids. Regurgitation of undigested food hours after a meal is a classic presentation. In addition, patients often complain of hoarseness, choking episodes, halitosis, and in severe cases, may have significant weight loss to the point of cachexia. Patients may also present with recurrent pneumonia. Friederich von Zenker described the diverticulum and assigned his name in 1877 (1). The pathophysiology of the Zenker’s diverticulum is thought to be chronic spasm or stricture of the cricopharyngeus muscle.

REFERENCES 1. Zenker FA, von Ziemessen H. Krankheiten des oesophagus. In: Handbuch der specciellen Pathologie und Therapie. ), Leipzig: FC Vogel, 1877, p. 187. 2. McConnell FMS, Hood D, Jackson K, et al. Analysis of intrabolus forces in patients with Zenkers diverticulum. Laryngoscope 1994;104:571–581. 3. Blitzer A, Brin MF. Use of botulinum toxin for diagnosis and management of cricopharyngeal achalasia. Otolaryn. Head and Neck Surg 1997;116:328–330. 4. Schneider I, Thumfart WF, Pototschnig C, et al.

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