Transorbito-maxillary percutaneous endoscopic gastrostomy. / Transorbitomaxillaris percutan endoszkópos gastrostomia.

Összefoglaló. Fej-nyaki daganattal diagnosztizált és kezelt betegeknél a szájon keresztüli táplálás gyakran nem lehetséges vagy nehezítetté válik a kezelés valamelyik fázisában. A beteg enteralis táplálásának biztosítására tartós és hatékony megoldást kell nyújtanunk, erre megfelelo választás lehet a percutan endoszkópos gastrostomia. A fej-nyaki régióban a daganat elhelyezkedése, kiterjedtsége és a mutétek miatt megváltozott anatómiai viszonyok sokszor gátat szabnak a gasztroszkóp hagyományos, szájon át történo sikeres levezetésének, és így különleges megoldásokra lehet szükség. Közleményünkben egy, a szakirodalomban is ritkán alkalmazott percutan endoszkópos gastrostomakészítésrol számolunk be. A bemutatott esetben egy kiterjedt, rosszindulatú fej-nyaki daganat miatt totális maxillectomián és orbitaexenteratión átesett betegben a mutét következtében kialakult arcdefektuson át történt a gastroscopia és a tápszonda levezetése, ugyanis komplett szájzár következtében a beteg a táplálkozásra képtelen volt. A fent említett módszerrel sikerült a beteg hosszú távú enteralis táplálását megoldani minimálinvazív módon. Az összetett kóros esetek gyakran állítják kihívások elé a gyakorló klinikust. Esetbemutatásunkkal szeretnénk felhívni a figyelmet a hagyományos, megszokott módszerek helyett sokszor nagyobb sikerrel alkalmazható, személyre szabott terápiás lehetoségekre. Orv Hetil. 2022; 163(3): 116-119. Summary. Peroral, enteral feeding is often impossible in patients with head and neck cancer. Percutaneous endoscopic gastrostomy is a well-established, quick, minimally invasive, and safe procedure for providing long-term enteral feeding. Space-occupying tumour mass and altered anatomy due to surgery inhibit the gastroscope's peroral introduction and the feeding tube's placement in some instances. Various access routes and modified insertion techniques are recommended to overcome the feeding tube insertion challenges. We present a rare case of a 64-year-old head and neck cancer patient who was unable to eat orally due to trismus and had a facial soft tissue defect following total maxillectomy and orbital exenteration. A complete oesophago-gastro-duodenoscopy and feeding tube insertion were performed transfacially. Percutaneous endoscopic gastrostomy was successful and uneventful via the maxillary and orbital soft tissue facial defect. No complication was noted, and long-term enteral feeding of the patient was provided in a minimally invasive way. Surgeons often face challenging cases when treating patients with head and neck cancer. The modification of standard procedures is sometimes required to adapt surgical techniques to the patient's specific case. Orv Hetil. 2022; 163(3): 116-119.

[Hyperplastic and inflammatory fibroid polypoid lesions of the stomach. Case report and a mini review]. / A gyomor polipjairól egy hyperplasticus és egy inflammatoricus fibroid elváltozás kapcsán.

The authors report the case of a 75-year-old woman with significant gastrointestinal bleeding caused by a large hyperplastic polyp and a smaller inflammatory fibroid polyp. Both polyps were removed endoscopically successfully. The authors give an overview of the endoscopic picture of the different kinds of stomach polyps with their histologic patterns, etiology, relation to Helicobacter pylori infection, malignant potential and therapeutic options based on the available literature.

[Secondary IgA-nephropathy in gastroenterological diseases]. / Szekunder IgA-nephropathia gasztroenterológiai betegségekben.

IgA-nephropathy is the most common primary chronic glomerulonephritis worldwide. Beside the primary IgA-nephropathy (IgA-nephropathy with an unknown origin), there are more and more cases, which are associated with diseases of other organs. Although the causality is often not obvious, these forms are called secondary IgA-nephropathy. In this study, the authors cover only the secondary forms of IgA-nephropathy with relation to gastroenterology in a broader sense that includes the liver. They would like to draw the attention to the necessity of analyzing also the associate occurrence of gastrointestinal diseases (principally liver diseases, coeliac disease, Crohn's disease, ulcerative colitis) in patients with IgA-nephropathy, as well. They think that it would be expedient to organize a nationwide clinical analysis that would search the frequency of occurrence of IgA-nephropathy in the above mentioned gastrointestinal diseases.

[Prolonged hiccups causing worsened quality of life--successful medical therapy]. / Az eletminoség romláshoz vezeto makacs csuklas--sikeres gyógyszeres kezelés.

Hiccups are intermittent, involuntary spasmodic contractions of the diaphragm and the intercostal muscles leading to the cessation of inspiration due to an abrupt closure of the glottis. Hiccups are usually innocuous phenomena, which could easily be terminated by simple manoeuvres but sometimes they become permanent and intractable causing significant decline in the patient's quality of life. Besides a number of provoking exogenous factors hiccups are caused by organic or psychical disorders. This why in cases of permanent hiccups detailed investigations are important. Beyond physical manoeuvres, pharmacotherapy, surgical intervention and some other therapeutic measures may be effective forms of treatment. In the present report the authors give a review of two patients, whose permanent hiccups were successfully treated with combined medical therapy. They review the causes and therapy of permanent hiccups and call the attention to the therapeutic value of baclofen, a gamma-aminobutyric acid analog compound.