OBJETIVO: Estudar os achados radiológicos encontrados na seriografia digestiva alta no pós-operatório tardio de cirurgia de Fobi-Capella. MATERIAIS E MÉTODOS: Estudo radiológico de 41 pacientes realizado seis a nove meses após a cirurgia de Fobi-Capella. RESULTADOS: As alterações encontradas foram hérnia hiatal (17%), refluxo gastroesofágico (19,5%) e deslizamento do anel (4,8%). Os achados menos freqüentes foram fístula enterocutânea (2,4%), estenose da anastomose gastrojejunal (2,4%), bezoar (2,4%) e não-visualização do anel em decorrência da sua retirada por intolerância (2,4%). As alterações anatômicas da cirurgia foram claramente demonstradas. CONCLUSÃO: O estudo foi capaz de demonstrar as alterações anatômicas e as complicações da cirurgia de Fobi-Capella.
ObjectiveTo identify and classify the radiographic patterns of megaesophagus in Chagas
disease, as seen on esophagograms and chest X-rays.Materials and MethodsThis was a prospective study of 35 patients diagnosed with esophageal disease
via manometry. The changes found on esophagograms were stratified according
to Rezende's classification, divided into four categories (grades I through
IV) determined by the degree of dilatation and impairement of esophageal
motility. We subsequently correlated that ranking with the chest X-ray
findings: gastric air bubble; air-fluid level; and mediastinal widening.ResultsAmong the 35 patients, the esophageal disease was classified as grade I in 9
(25.7%), grade II in 3 (8.6%), grade III in 19 (54.3%), and grade IV in 4
(11.4%). None of the patients with grade I esophageal disease showed changes
on chest X-rays. In two of the three patients with grade II disease, there
was no gastric air-bubble, although there were no other findings in any of
the grade II patients. Of the 19 patients with grade III disease, 15 had
abnormal findings on X-rays. All four patients with grade IV disease showed
abnormalities.ConclusionThe use of Rezende's classification is feasible, encompassing findings
ranging from the subtle changes that characterize the initial phases of
esophageal disease to the complete akinesia seen in dolicomegaesophagus.
Chest X-ray findings are more common in patients with advanced stages of the
disease and indicate the degree of esophageal involvement in Chagas
disease.
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