Spontaneous intramural oesophageal haematoma is a rare disease and presents with the classic triad of symptoms of chest pain, dysphagia and haematemesis. Flexible oesophagoscopy and contrast enhanced CT scan is helpful in the diagnosis and also to exclude other sinister pathologies. Most are managed conservatively and the patient we report also was managed conservatively with a successful outcome.
Oesophageal penetration and migration of foreign bodies are fairly rare occurrences. Most reported cases in the literature involve fish bones, which are eventually found in the lateral neck soft tissue or thyroid lobule. We present a case of a migrating fish bone in an elderly female which was found embedded in her right sternocleidomastoid muscle. The fish bone was successfully removed via neck exploration. Appropriate literature is reviewed.
A female patient presenting with post-prandial epigastric pain and weight loss was diagnosed to have oesophageal tuberculosis by endoscopic biopsy. She responded well to standard anti-tuberculosis treatment.
Cysts of the oesophagus are unusual findings and they are classified according to the embryological site of origin. It may represent inclusion cysts, retention cysts and developmental cysts. We present a case of keratinous inclusion cyst of the lower oesophagus in a 71-year-old Malay woman who presented with dyspepsia and severe epigastric pain. An oesophago-gastro-duodenoscopy demonstrated a sliding hiatus hernia with whitish ulcer-like lesion at the lower oesophagus. Biopsy from the lesion revealed a keratinous inclusion cyst. The patient was given pantoprazole and put on regular follow-up for monitoring any other development.
Tuberculosis remains an important cause of morbidity and mortality, especially in underdeveloped and developing nations. Manifestations could be nonspecific and may mimic many other conditions, including malignancies. Oesophageal involvement is surprisingly rare despite the high prevalence of pulmonary tuberculosis and the close proximity of these two structures. We report two cases of oesophageal tuberculosis; a 73-year-old man with simultaneous oesophageal, stomach and duodenal involvement, and a 45-year-old man with isolated oesophageal involvement. Underlying malignancies were initially suspected in both cases, but they were eventually diagnosed as tuberculosis.
Massive goiter with retrosternal extension may impose additional risk such as difficult intubation, tracheomalacia, and possibility of different incision and approach including sternotomy. We would like to report a case of massive goiter encasing major neck structures and how it was managed.