Search

A patient with Cronkhite-Canada syndrome had multiple juvenile colonic polyps with hyperplastic, adenomatous, and mixed villous and adenomatous changes. A Dukes B mucus-secreting adenocarcinoma of the cecum was also present. Currently considered a benign disease, the Cronkhite-Canada syndrome may be a premalignant disorder, as our patient's course suggests. We review the literature in this regard.

Intramural diverticulosis of the esophagus is a rare disease of unknown etiology with a characteristic esophagogram consisting of small flask-like diverticula. This paper presents the ninth patient with this disease. There has been confusion about the etiology of the disease and its relation to monilial esophagitis, and this differential diagnosis is discussed. Although the etiology remains speculative, we conclude that intramural diverticulosis of the esophagus may develop in a normal esophagus and that it is not caused byMonilia.

A case of adenocarcinoma of the stomach spreading to the esophagus is described. It was well seen on computerized tomography and appeared more ominous than the esophagram. The latter illustrated an appearance simulating narrowing secondary to peptic esophagitis; the former demonstrated a relatively large encompassing mass. The definitive diagnosis was made during endoscopy and confirmed by biopsy. Although computerized tomography is not considered the method of choice for establishing an abnormality in this organ, it can occasionally help. It can usually show the total extent of the tumor better. Additional cases are presented.

THE INGESTION of lye, either as a suicidal measure or accidentally, leads to multiple problems. Lye (sodium hydroxide) is highly destructive and may lead to perforation of the esophagus by liquefaction necrosis.1Hypovolemic shock and bacterial invasion are other immediate dangers of lye ingestion. Additional well-known complications are stricture formation, pulmonary insufficiency as the result of repeated aspirations, and perforation of the esophagus or stomach as a result of endoscopic examination. Necrosis of the tissues may extend through the entire esophageal wall, producing periesophagitis, pleurisy, pericarditis, mediastinitis, and bronchoesophageal fistula.2Chemical gastritis, peritonitis, pulmonary edema, and laryngeal obstructions are other possible complications. Cardona and Daly3reported duodenal ulcerations and strictures as a result of lye ingestion. The effects of alkali ingestion are seen primarily in the upper gastrointestinal tract.4In our patient, lye ingestion led to perforations of the small intestine and colon. To our knowledge