title: [Penetration of the esophageal and gastric ulcers to the cardioaortic system following hiatus hernia: a lethal complication in the severely-handicapped].
abstract: Among the severely-handicapped, hiatus hernia (HH) and/or gastroesophageal regurgitation (GER) are not uncommon. We report here three patients with HH and/or GER. Two of them died of massive hemorrhage in the alimentary tract from the heart or the thoracic aorta due to penetration of the gastric or esophageal ulcer. The third patient died of pneumonia, but autopsy proved multiple esophageal ulcers, one of which reached the wall of the brachiocephalic artery without penetration. We propose that proper treatment for HH and/or GER is required for the severely-handicapped, including surgical intervention, before their general conditions become worse and decompensatory.
authors.affiliation: Department of Pediatrics, Metropolitan Medical Center of the Severely Handicapped, Tokyo.
authors.forename: K
authors.initials: K
authors.lastname: Yamada
authors.forename: N
authors.initials: N
authors.lastname: Fueki
authors.forename: M
authors.initials: M
authors.lastname: Ito
authors.forename: K
authors.initials: K
authors.lastname: Hirasawa
authors.forename: N
authors.initials: N
authors.lastname: Suzuki
authors.forename: K
authors.initials: K
authors.lastname: Kurata
authors.forename: K
authors.initials: K
authors.lastname: Takada
authors.forename: J
authors.initials: J
authors.lastname: Satoh
authors.forename: Y
authors.initials: Y
authors.lastname: Morimatsu
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic; D001019:Aortic Rupture / Q000209:etiology*; D006233:Persons with Disabilities; D004935:Esophageal Diseases / Q000150:complications*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006341:Heart Rupture / Q000209:etiology*; D006352:Heart Ventricles; D006551:Hernia, Hiatal / Q000150:complications*; D006801:Humans; D008297:Male; D013276:Stomach Ulcer / Q000150:complications*; D014456:Ulcer / Q000150:complications