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Single-step pull-type gastrostomy tube (PGT) placement is a method involving gastric puncture with a curved 18-gauge trocar needle allowing retrograde cannulation of the gastroesophageal junction without use of a sheath or snare. This retrospective review of 102 patients who underwent single-step PGT placement demonstrated 91% success in advancing the wire up the esophagus using only the curved trocar. Successful placement of a gastrostomy tube was 100%. Two major and 2 minor complications occurred within 30 days, all unrelated to the single-step technique. Mean fluoroscopy time for all patients was 5.1 min (range, 1.5-19.2 min). Single-step PGT placement is an effective, safe, fast, and equipment-sparing method for gastrostomy placement.
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http://dx.doi.org/10.1016/j.jvir.2019.05.022 | DOI Listing |
Eur J Case Rep Intern Med
August 2025
Department of Clinical Pharmacology, Hospital Clínico San Carlos; IdISSC, Madrid, Spain.
Background: Certain scientific publications suggest that medications with high protein binding, such as phenytoin, have lower-than-expected serum levels in patients receiving enteral nutrition (EN) preparations or nutritional supplements. Valproic acid (VPA) is highly protein bound but currently no interactions with EN that would reduce serum levels have been documented.
Case Description: A 69-year-old patient receiving enteral VPA oral solution via a nasojejunal tube experienced a clinically significant decrease in serum concentration when EN was initiated.
Surg Case Rep
September 2025
Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Toyama, Japan.
Introduction: There are no reports of patients undergoing McKeown esophagectomy for esophageal cancer after undergoing pancreaticoduodenectomy for pancreatic cancer. We report the case of a patient who underwent subtotal esophagectomy and colon reconstruction after pancreaticoduodenectomy using the mesenteric approach.
Case Presentation: A 71-year-old male was diagnosed with advanced esophageal cancer.
Cerebellum
September 2025
Department of Neurology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Multiple system atrophy (MSA) is a progressive, adult-onset neurodegenerative disorder involving autonomic failure, cerebellar ataxia, and parkinsonism. Patients often require invasive interventions, such as gastrostomy or tracheostomy, and sudden death is common. This study aimed to elucidate patterns of invasive treatment and identify risk factors for tracheostomy or sudden death within 5 years of onset.
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September 2025
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
Objective: In head and neck cancer (HNC) survivors not actively receiving dysphagia care, long-term dysphagia prevalence, dysphagia-related complications, and quality of life outcomes remain poorly understood. Understanding these outcomes is critical for creating effective HNC survivorship programs.
Methods: HNC survivors who completed cancer treatment > 2 years prior who had not undergone a swallow evaluation or therapy for > 1 year completed the MD Anderson Dysphagia Inventory (MDADI) and reported dysphagia-related complications.
Am J Case Rep
September 2025
Division of Pediatric Surgery, Department of Surgery, Children's Hospital Colorado, Aurora, CO, USA.
BACKGROUND Ex-utero intrapartum treatment (EXIT)-to-airway is a complex perinatal procedure performed in the case of potential postnatal airway obstruction. It requires an experienced multidisciplinary team and meticulous surgical planning based on fetal imaging. This report describes the use of EXIT-to-airway for a large cervical teratoma with extension into the mediastinum.
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