El Salvador Atlas of Gastrointestinal VideoEndoscopy. A Large Database of Images and Video Clips with Cases Reported.
El Salvador Atlas of Gastrointestinal VideoEndoscopy
Giant leiomyoma of the esophagus. A 45 year-old male, physician, previously asintomatic a giant leiomyoma was found at the level of the middle third. Hypomotility of the distal esophagus, hiatal hernias and GERD are common findings. Therefore, evaluation for GERD should be considered before and after surgery for esophageal leiomyoma.

Video Endoscopic Sequence 1 of 5.

 Giant leiomyoma of the esophagus.
 A 45 year-old male, physician, previously asintomatic a
 giant leiomyoma was found at the level of the middle third.
 
 
 Hypomotility of the distal esophagus, hiatal hernias and
 GERD are common findings. Therefore, evaluation for
 GERD should be considered before and after surgery for
 esophageal leiomyoma.
 

Leiomyoma is the most common benign tumour found in the esophagus but it is, however, a rare neoplasm; in fact of all esophageal tumours, benign tumours account for fewer than 10%, of which 4% are leiomyomas. Leiomyomas should be removed when diagnosed, even if asymptomatic, because malignancy cannot otherwise be excluded and symptoms are likely to develop if treatment is delayed or omitted. Enucleation of esophageal leiomyoma is a safe and effective procedure.

Video Endoscopic Sequence 2 of 5.

 Leiomyoma is the most common benign tumour found in the
 esophagus but it is, however, a rare neoplasm; in fact of all
 esophageal tumours, benign tumours account for fewer than
 10%, of which 4% are leiomyomas. Leiomyomas should be
 removed when diagnosed, even if asymptomatic, because
 malignancy cannot otherwise be excluded and symptoms
 are likely to develop if treatment is delayed or omitted.
 Enucleation of esophageal leiomyoma is a safe and
 effective procedure.
Leiomyomas represent a hyperproliferation of interlacing bundles of smooth muscle cells that are well-demarcated by adjacent tissue or by a smooth connective tissue capsule. They usually arise as intramural growths, most commonly along the distal two thirds of the esophagus. They are multiple in approximately 5% of patients. The majority of leiomyomas have been discovered incidentally during evaluation for dysphagia or during autopsy. Bleeding rarely occurs in cases of benign disease but typically is observed with leiomyosarcoma, the malignant counterpart of this tumor. The potential for malignant degeneration of leiomyomas is extremely small. In the distal esophagus, leiomyomas may reach large proportions and may encroach on the cardia of the stomach.

Video Endoscopic Sequence 3 of 5.

 Leiomyomas represent a hyperproliferation of interlacing
 bundles of smooth muscle cells that are well-demarcated by
 adjacent tissue or by a smooth connective tissue capsule.
 They usually arise as intramural growths, most commonly
 along the distal two thirds
 of the esophagus. They are multiple in approximately 5%
 of patients. The majority of leiomyomas have been
 discovered incidentally during evaluation for dysphagia or
 during autopsy.
 Bleeding rarely occurs in cases of benign disease but
 typically is observed with leiomyosarcoma, the malignant
 counterpart of this tumor. The potential for malignant
 degeneration of leiomyomas is extremely small. In the
 distal esophagus, leiomyomas may reach large proportions
 and may encroach on the cardia of the stomach.
Patient have been suffered of GERD since many years. The endoscopic image as well as the video clip displays a reflux esophagitis with Barret esophagus.

Video Endoscopic Sequence 4 of 5.

 Patient have been suffered of GERD since many years.
 The endoscopic image as well as the video clip displays
 a reflux esophagitis with Barret esophagus.
Hypomotility of the distal esophagus, hiatal hernias and GERD are common findings in patient with leiomyomas. Therefore, evaluation for GERD should be considered before and after surgery for esophageal leiomyoma.

Video Endoscopic Sequence 5 of 5.

 Hypomotility of the distal esophagus, hiatal hernias and
 GERD are common findings in patient with leiomyomas.
 Therefore, evaluation for GERD should be considered
 before and after surgery for esophageal leiomyoma.
 

Tracheal Bifurcation. The endoscope is occasionally passed inadvertently into the trachea rather than the esophagus, for example, in patients who have difficulty initiating the act of swallowing. Tracheal rings will be evident, as will the bifurcation into right and left mainstream bronchi.

Tracheal Bifurcation.

 The endoscope is occasionally passed inadvertently
 into the trachea rather than the esophagus, for example,
 in patients who have difficulty initiating the act of
 swallowing.
 Tracheal rings will be evident, as will the bifurcation into
 right and left mainstream bronchi.
Small Traqueo-Esophageal Fistula. A 90 year- old male with old pulmonar tuberculosis sequels. We found the image displays here and some biopsies where taken at the time of the endoscopy we found this image in the superior third of the esophagus, We did not have a diagnosis and therefore proceed to biopsy this lesion. Esophagogram was obtained, showing small fistula between up third of esophagus and traquea.

Small Traqueo-Esophageal Fistula.

 A 90 year- old male with old pulmonar tuberculosis sequels.
 We found the image displays here and some biopsies
 where taken at the time of the endoscopy we found this
 image in the superior third of the esophagus, We did not
 have a diagnosis and therefore proceed to biopsy this
 lesion.
 Esophagogram was obtained, showing small fistula between
 up third of esophagus and traquea.
  
Foreign Body Ingestion.

Video Endoscopic Sequence 1 of 7.

Foreign Body Ingestion.

 Coins are probably the most commonly ingested foreign
 bodies in children. This 20 month-old girld had a penny,
 stuck in her esophageal inlet.
 A coin in the esophagus appears as a round metallic object
 on an AP projection.

 As children explore the world, they will inevitably put
 foreign bodies into their mouths and swallow some of them.

 Most swallowed foreign bodies pass harmlessly through the
 gastrointestinal (GI) tract. Foreign bodies that damage the
 GI tract, become lodged, or have associated toxicity must
 be identified and removed. Children with preexisting GI
 abnormalities (eg, tracheoesophageal fistula, stenosing
 lesions, previous GI surgery) are at an increased risk for
 complications.                 

The coin has been lodged immediately below the upper esophageal sphincter. Most complications of pediatric foreign body ingestion are due to esophageal impaction, usually at 1 of 3 typical locations. The most common site of esophageal impaction is at the thoracic inlet. Defined as the area between the clavicles on chest radiograph, this is the site of anatomical change from the skeletal muscle to the smooth muscle of the esophagus. The cricopharyngeus sling at C6 is also at this level and may "catch" a foreign body. About 70% of blunt foreign bodies that lodge in the esophagus do so at this location. Another 15% become lodged at the mid esophagus, in the region where the aortic arch and carina overlap the esophagus on chest radiograph. The remaining 15% become lodged at the lower esophageal sphincter (LES) at the gastroesophageal junction.

Video Endoscopic Sequence 2 of 7.

The coin has been lodged immediately below the upper esophageal sphincter.

 Most complications of pediatric foreign body ingestion are
 due to esophageal impaction, usually at 1 of 3 typical
 locations. The most common site of esophageal impaction
 is at the thoracic inlet. Defined as the area between the
 clavicles on chest radiograph, this is the site of anatomical
 change from the skeletal muscle to the smooth muscle of
 the esophagus. The cricopharyngeus sling at C6 is also at
 this level and may "catch" a foreign body. About 70% of
 blunt foreign bodies that lodge in the esophagus do so at
 this location. Another 15% become lodged at the mid
 esophagus, in the region where the aortic arch and carina
 overlap the esophagus on chest radiograph. The remaining
 15% become lodged at the lower esophageal sphincter
 (LES) at the gastroesophageal junction.

                            

Because many patients who have swallowed foreign bodies are asymptomatic, physicians must maintain a high index of suspicion. The majority of ingested foreign bodies pass spontaneously, but serious complications, such as bowel perforation and obstruction, can occur. Foreign bodies lodged in the esophagus should be removed endoscopically, but some small, blunt objects may be pulled out using a Foley catheter or pushed into the stomach using bougienage. Once they are past the esophagus, large or sharp foreign bodies should be removed if reachable by endoscope.

Video Endoscopic Sequence 3 of 7.

 Because many patients who have swallowed foreign bodies
 are asymptomatic, physicians must maintain a high index
 of suspicion. The majority of ingested foreign bodies pass
 spontaneously, but serious complications, such as bowel
 perforation and obstruction, can occur. Foreign bodies
 lodged in the esophagus should be removed endoscopically,
 but some small, blunt objects may be pulled out using a
 Foley catheter or pushed into the stomach using
 bougienage. Once they are past the esophagus, large or
 sharp foreign bodies should be removed if reachable by
 endoscope.
Foreign body ingestion endoscopic removal. Foreign body ingestion often requires endoscopic removal, but the majority of the foreign body may pass through the whole gut without creating any problem to the patient. However, any foreign body which is large and impacted, any sharp foreign body should be removed immediately. Foreign bodies less than 2.5cm in diameter usually pass through gastrointestinal tract without difficulty. The common sites of impaction of foreign body in esophagus are postcricoid region, level of aortic arch, left main bronchus and the diaphragm. But there is one more site of impaction especially in cases of flat objects like coin which is at level of T1 i.e., thoracic inlet. Rarely foreign body not large in size may be impacted in esophagus in cases of strictures, or smooth muscle spasm.

Video Endoscopic Sequence 4 of 7.

Foreign body ingestion endoscopic removal.

 Foreign body ingestion often requires endoscopic removal,
 but the majority of the foreign body may pass through the
 whole gut without creating any problem to the patient.
 However, any foreign body which is large and impacted,
 any sharp foreign body should be removed immediately.
 Foreign bodies less than 2.5cm in diameter usually pass
 through gastrointestinal tract without difficulty. The
 common sites of impaction of foreign body in esophagus
 are postcricoid region, level of aortic arch, left main
 bronchus and the diaphragm. But there is one more site of
 impaction especially in cases of flat objects like coin which
 is at level of T1 i.e., thoracic inlet. Rarely foreign body not
 large in size may be impacted in esophagus in cases of
 strictures, or smooth muscle spasm.                                                                               
Sharp foreign body can get impacted from base of tongue to lower end of esophagus. If they are not removed at the earliest can cause erosion, perforation, abscess or mediastinitis.

Video Endoscopic Sequence 5 of 7.

 Sharp foreign body can get impacted from base of tongue
 to lower end of esophagus. If they are not removed at the
 earliest can cause erosion, perforation, abscess or
 mediastinitis. Objects that have passed the esophagus
 generally do not cause symptoms unless complications,
 such as bowel perforation or obstruction, occur. Patients
 with objects lodged in the esophagus may be asymptomatic
 or may present with symptoms varying from vomiting or
 refractory wheezing to generalized irritability and
 behavioral disturbances

                    
Foreign body ingestion is a potentially serious problem that peaks in children aged six months to three years. It causes serious morbidity in less than one percent of all patients.

Video Endoscopic Sequence 6 of 7.

 Foreign body ingestion is a potentially serious problem that
 peaks in children aged six months to three years. It causes
 serious morbidity in less than one percent of all patients.
 An estimated 40 percent of foreign body ingestions in
 children are not witnessed, and in many cases, the child
 never develops symptoms.

                   
A penny has been removed endoscopically. Gastrointestinal tract ingested foreign bodies are common problems, particularly in children. The most common ingested foreign bodies are coins. Longstanding esophageal foreign bodies may cause failure to thrive or recurrent aspiration pneumonia. Esophageal perforation may result in neck swelling, crepitations, and pneumomediastinum. If perforation occurs in the stomach or intestines, fever and abdominal pain and tenderness may develop. Bowel obstruction by a foreign body may cause abdominal distension, pain, and tenderness. Common sites for obstruction by an ingested foreign body include the cricopharyngeal area, middle one third of the esophagus, lower esophageal sphincter, pylorus, and ileocecal valve.

Video Endoscopic Sequence 7 of 7.

 A penny has been removed endoscopically.

 Gastrointestinal tract ingested foreign bodies are common
 problems, particularly in children. The most common
 ingested foreign bodies are coins.  

 Longstanding esophageal foreign bodies may cause failure
 to thrive or recurrent aspiration pneumonia. Esophageal
 perforation may result in neck swelling, crepitations, and
 pneumomediastinum. If perforation occurs in the stomach
 or intestines, fever and abdominal pain and tenderness may
 develop. Bowel obstruction by a foreign body may cause
 abdominal distension, pain, and tenderness. Common sites
 for obstruction by an ingested foreign body include the
 cricopharyngeal area, middle one third of the esophagus,
 lower esophageal sphincter, pylorus, and ileocecal valve.                                                               

Status after 36 year of lye ingestion Circular Scars are observed in the middle third of the Esophagus.

Video Endoscopic Sequence 1 of 2.

Status after 36 year of lye ingestion

Circular Scars are observed in the middle third of the Esophagus.

 This 40 year-old female, at the age of 4, suffers an accident
 ingesting lye, for more than two years underwent
 continuous sessions of dilation of the esophagus.

 
In the image as well as the video clip a scar of gastrostomy is observed 34 year after.

Video Endoscopic Sequence 2 of 2.

In the image as well as the video clip a scar of gastrostomy is observed after 36 year .
Polypectomy snare -assisted removal of a foreign body impacted in the esophagus. A 76 year -old man with meat and rice’s residues were found at the cardias, which obstruct passage due a mild stenosis of the cardias, as a consequence of reflux esophagitis.

Video Endoscopic Sequence 1 of 2.

 Polypectomy snare -assisted removal of a foreign body
 impacted in the esophagus

 A 76 year -old man with meat and rice’s residues were
 found at the cardias, which obstruct passage due a mild
 stenosis of the cardias, as a consequence of reflux
 esophagitis.
 
Foreign body retrieval.. The meat and rice's are retrieval with the polypectomy snare.

Video Endoscopic Sequence 2 of 2.

 Foreign body retrieval.

 The meat and rice’s are retrieval with the polypectomy
 snare.
 
 

 
Esophageal obstruction by a meat bolus impacted in the esophagus. A 75 year-old female that has been under radiotherapy due to breast cancer. The image and the video display a piece of meat that was retrieved with the polypectomy snare.

Foreign Body Retrieval.

 Esophageal obstruction by a meat bolus impacted in the
 esophagus.
 A 75 year-old female that has been under radiotherapy due
 to breast cancer.
 The image and the video display a piece of meat that was
 retrieved with the polypectomy snare.