106. Anatomical disorders and inflammations of esophagus. Esophageal varices.

Question 1

Atresia and tracheoesophageal fistulas

Answer 1

rare congenital defect

usually present togethr

Question 2

Stenosis (stricture)

Answer 2

acquired or congenital defect

causes: injury, inflammation, chronic GERD, irradiation
patho: fibrous thickening of the submucosa with atrophy of the muscularis propria
complication: dysphagia

Question 3

achalasia

Answer 3

failure of LES to relax due to neuromuscular dysfunction resulting in massive dilation of colon

primary achalasia: idiopathic, distal esophageal inhibitory neurons fail

secondary achalasia: chagas disease- destruction of myenteric plexus

Question 4

Hiatus hernia

Answer 4

herniation of stomach through esophageal hiatus in diaphragm

types:
1. sliding (esophagealgastric hernia)

3. rolling (paraesophageal hiatus)

Question 5

Esophageal diverticulum

Answer 5

definition: outpouching of esophageal wall at weak area
congenital: usually at upper end of esophagus or at bifurcation of trachea
acquired: due to increased pressure secondary to obstruction (chronic inflammation, cancer)

1. Zenkers type: upper esophagus (pulsion)
2. Epiphrenic type: lower esophagus (traction mechanism)

Question 6

Esophageal laceration

Answer 6

due to prolonged vomiting, reflex relaxation of gastro-esophageal wall fails causing wall to stretch and tear

types

1. mallory-weiss syndrome: superficial longitudinal tears that usually heal themselves
2. Boerhaave syndrome: transmural esophageal tears and ruptures, can result in medistinitis and subcutaneous emphysema

Question 7

Esophageal varices

Answer 7

dilation of veins in lower 1/3 of esophagus
causes:
1. cirrhosis
2. hepatic schistosomiasis

patho: portal hypertension –> reverse flow to portocaval anastomoses shunt blood to caval system –> dilated submucosal veins
complication: can rupture and result in life-threatening bleeding

Question 8

esophagitis

Answer 8

definition: inflammation of esophagus

1. GERD