Foreign bodies in the gastrointestinal tract. Our cases and a review of the literature

The ingestion or introduction of foreign bodies is a common situation in emergency surgery. The patients who usually ingest foreign bodies for different reasons are children, psychotics, alcoholics, prisoners and old people. The authors analyzed 65 cases observed in the I Institute of Surgery of the University of Rome "La Sapienza": 45 males and 20 females. Both the anal introduction and ingestion may be accidental or voluntary. The incidence of complications is estimated about 5 to 7%. The authors underline the opportunity of a conservative removal through endoscopic procedures especially for intraesophageal corps. This procedure is recommended to reduce morbidity and mortality rates, as well as hospitalization and social costs.     

Foreign bodies in the larynx in infancy

Three cases of foreign bodies in the larynx are described. The mode of presentation, management, and the importance of early diagnosis to decrease the number and severity of complications are stressed.     

Malignant systemic diseases of the digestive tract

In about 5-6% of all patients with malignant myeloproliferative disorders the gastrointestinal tract is involved with macroscopic lesions. The most common sites of digestive manifestations are stomach, small bowel, pancreas and colon. Multiple irregular ulcers, doughy infiltration of the bowel wall, multiple nodules and diffuse polyposis of the colon are classic patterns of secondary lymphoma of the gut. Prognosis is considerably impaired by gastroenterological symptoms.     

Hydatid liver cyst perforation into the digestive tract

Complications of liver hydatid disease include those related to the compression of adjacent viscus, to the infection of the cyst's contents or to the perforation of the cyst. Perforations into hollow abdominal organs are rare, and can occur secondary to the infection of the cyst or to a primary pathology of the perforated organ. We report on 2 cases of perforation of a liver cyst into the duodenum, 1 due to the presence of a duodenal ulcer, and 1 secondary to a hydatid abscess. The surgical treatment of the lesions and their complications was, in both cases, successful.     

Use of Caproiod thread in surgery of the digestive tract

The results of experimental and clinical studied of the suture material "Caproiod" are presented. The advantage of the material suggested is its favourable effect on regenerative processes in the region of suture and anastomoses which resulted in their increased hermeticity. Use of "Caproiod" permits to prevent the development of postoperative complications caused by a quality of the suture material.     

Foreign bodies in the bladder: report of four cases

This report presents the author's experience with four cases of foreign bodies in the bladder during a urological practice that spanned three different geographical locations. Relevant clinical aspects of this condition are discussed as well as technical tips given by various authors for the safe retrieval of such objects.     

Foreign bodies in the ear; report of 40 cases

BACKGROUND: Foreign bodies in the external ear canal present a frequent situation in pediatric practice. It is generally benign, but infectious complications may occur. POPULATION: Between January 1996 and March 1997, 35 children with a foreign body in the ear canal were treated in the ENT department of Robert-Debré hospital. RESULTS: Age ranged from 15 months to 14 years, with a mean of 6.5 years. The sex ratio was 1.2 (19 boys/16 girls). Five children had bilateral foreign bodies. The most frequent foreign bodies were pearls (8/40) and cockroaches (7/40). Eleven children had complications: ear canal laceration in five cases, otitis externa in five cases, cervical adenitis in three cases, general septic syndrome with fever in one case, and drum perforation in one case. CONCLUSION: The methods of extraction and the management of the complications are discussed.     

Treatment of MALT lymphoma of the digestive tract]

Mucosa-associated lymphoid tissue (MALT) is an autonomous part of the immune system with a specific function, histological structure and circulation of cells. As a result of malignant transformation of this tissue maltomas develop, peripheral extranodal non-Hodgkin lymphomas of B-origin more than two-thirds of which are found in the digestive system. The authors investigated in a retrospective study the effectiveness of different types of treatment of maltomas of the digestive tract with a low and high grade of malignity in 16 patients. It appears that splenectomy is not necessary in these patients and that the effectiveness of primary chemotherapy with a view of inducing complete remission of the disease is comparable with surgical treatment and subsequent adjuvant treatment without deterioration of the patient s life by mutilating surgery. An integral part of treatment of gastric maltomas is eradication of infection caused by Helicobacter pylori.     

Beta-carotenoids and their potential use in diseases of the digestive tract

Flying personal with chronic hepatitis received beta-caratinoid vetoron. The latter proved to be an effective immunomodulator improving lipid peroxidation, clinical and morphological characteristics in the personnel with chronic persistent hepatitis. Follow-up gives proves on longer physical fitness for service of those pilots who have taken beta-caratinoids.     

Sugar consumption and human cancer in sites other than the digestive tract

In order to assess the relationship between dietary intake of sugar and cancer a comprehensive search of the scientific literature was undertaken. An earlier publication details an analysis of studies relating to cancers of the digestive tract (Burley, 1997). Here, a total of 69 publications were reviewed which reported the results of ecological, case-control or cohort studies which had assessed the relationship between dietary sugar intake or sucrose-containing foods and risk of cancer at other sites. Cancer sites reviewed included the breast, pancreas, prostate, testis, female reproductive system, lung and upper aerodigestive tract and bladder. For most of these cancer sites the number of studies was insufficient to reach a conclusion. For breast cancer, the data on international per capita sugar intakes suggest a consistent positive correlation with breast cancer mortality rates. However, this relationship is not consistent in within-country ecological studies or in case-control studies, in which sugar intakes have been assessed as mono- and disaccharides or as sucrose. There is some suggestion of a weak increase in risk of breast cancer with high consumption of sucrose-containing foods, such as cakes and biscuits. However, these foods provide a range of other nutrients, particularly fat, which may also be implicated in the development of breast cancer, and further studies specifically designed to address this area are required. It is apparent that there is insufficient evidence to conclude whether sugar has a role in cancer at any site.     

Distribution of Salmonellae in the digestive tract and lymph node of carrier-dogs

The genetic activity of the antimicrobial food additives AF-2 and H-193 has been investigated in Saccharomyces cerevisiae. The strains chosen for the present studies were D5 for the induction of mitotic recombinational events and XV185-14C for the induction of reversion of the mutants lys1-1, his1-7 and homs3-7. When three concentrations (25, 50 and 100 mug/ml) of AF-2 were used in the reversion system of strain XV185-14C, there was an increase in the frequency of hom+ and his+ revertants as a function of incubation time, while the lysine mutant exhibited a very low frequency of induced reversion. When AF-2 and H-193 were compared at the same concentration and exposure time, AF-2 exhibited a higher genetic activity in both systems than H-193. However, H-193 was genetically more active in inducing revertants than AF-2, when the comparison was made at the same survival level. Cells of both haploid and diploid strains were found to be more sensitive to inactivation by AF-2 than by H-193 It should be pointed out that the solubility of H-193 was lower (about 4 mug/ml saturation) than the solubility of AF-2 (120 mug/ml saturation). The haploid strain was more sensitive to both compounds than the diploid strain.     

Upper digestive tract dyspepsia and early gastric cancer

AIM: The study of the frequency and evolution of upper digestive tract dyspepsia in a group of patients operated for early gastric cancer (EGC) and to perform a strategy of diagnosis for the patients with long term upper digestive tract dyspepsia. METHODS: Clinical data of 35 patients operated for EGC were retrospectively evaluated. The frequency, characteristics and evolution time of upper digestive tract dyspepsia, main when it began more than 6 months before surgery, were analyzed. Radiologic and endoscopic exams carried out for diagnosis were also evaluated. Histological diagnosis of surgical specimens were considered, looking for the presence of chronic atrophic gastritis, intestinal metaplasia, and peptic gastric ulcer. RESULTS: Long-term upper digestive tract dyspepsia was present in 27 patients (mean evolution time of 43.4 months). Clinical changes of previous symptoms that suggested gastric carcinoma were not found in 15 patients. Concurrent peptic gastric carcinoma were not found in 15 patients. Concurrent peptic gastric ulcer along with EGC was diagnosed by histology in 11 patients, and chronic atrophic gastritis and intestinal metaplasia were both present in the non-tumoral gastric mucosa in all cases. CONCLUSIONS: 1) Unspecific upper digestive tract dyspepsia is frequently found in patients with EGC. 2) Endoscopy should be the first exam performed in patients with upper digestive tract dyspepsia. 3) The patients with gastric ulcer, chronic atrophic gastritis or intestinal metaplasia must be submitted to sequential endoscopic follow-up.     

The endoscopic treatment of postoperative stenoses of the upper digestive tract

The authors compare their experience in dilatation of postoperative benign esophageal strictures. A total of 60 patients (37 males, 23 females: mean age 52), all with severe dysphagia, from January 1985 to September 1995, underwent endoscopic dilatation: 32 of these with Savary dilators and 28 with balloon dilators. Dilatation was effective in 93% in both groups. Two severe complications were recorded (1 heart attack and 1 perforation) in the group that underwent endoscopic dilatation with Savary dilators. During endoscopic management, pain recurred in 43% and 87% of cases after balloon or Savary dilatations, respectively. The authors believe balloon dilators are more effective, better tolerated and with less complications than Savary dilators. They reserve the management with Savary dilators to the extremely severe esophageal strictures.