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By Jovitas Skucas

Complex Imaging of the stomach is important to the working towards radiologist, and the extra senior radiology resident and fellow, who's searching for a heritage reference resource whilst discussing a advised imaging process with the referring general practitioner. The publication comprises broad lists, tables, line drawings and illustrations - ultrasonography, computed tomography, magnetic resonance photographs, scintigraphy. It bridges the interface among the referring clinician and radiologist whilst confronted with a sufferer suspected of getting a posh or more odd belly .

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A transabdominal laparoscopic technique is gaining popularity. The operation consists of dividing the lower esophageal circular muscles. An antireflux procedure such as a fundoplication is often added. Whether adoption of a laparoscopic approach will lead to an earlier surgical referral for these patients, who often undergo multiple endoscopic dilations, remains to be seen. On a long-term basis, an esophageal stricture, presumably secondary to reflux, is a complication of a myotomy performed for achalasia.

A,B: Two patients with primary esophageal malignant melanoma. Both tumors have an intraluminal polypoid appearance. Linear ulcers or fissures are evident in one (B). None resulted in lumen obstruction. C: Oral contrast-enhanced CT reveals an intraluminal tumor (arrow). Contrast surrounds this primary esophageal malignant melanoma. (From Gollub MJ, Prowda JC. Primary melanoma of the esophagus: radiologic and clinical findings in six patients. ) Metastases or Direct Invasion The esophagus is involved either by direct invasion from adjacent structures or metastases.

A rare malignant fibrous histiocytoma presents as a soft tissue polyp. A carcinosarcoma is uncommon in the esophagus. Histologically, these tumors show elements of both squamous cell carcinoma and sarcoma. Histogenesis is believed to involve metaplasia of some carcinomatous cells toward mesenchymal differentiation. Only rarely is a carcinosarcoma a result of simultaneous adjacent tumor development from both epithelial and mesenchymal tissue, identified by distinct immunoreactive and genetic clonalities in the two components.

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