1.5. Oesophageal Disease - Hypertensive (Nutcracker) Oesophagus Flashcards
What causes a Hypertensive Oesophagus?
This can be a continuation of Gastro-Oesophageal Reflux Disease
Is this disease more common in Males or Females?
Females
What is the Pathology of the Disease?
A Hypermotile Oesophagus results in Damage to the Myenteric Nerve Plexus, which causes an increase in Lower Oesophageal Pressure
What are the Clinical Signs of a Hypertensive Oesophagus?
- Weight Loss / Anorexia
- High Pressure in the Distal Oesophagus
- No Aperistalsis (Achalasia)
Why does Weight Loss / Anorexia occur?
Due to the problem getting food into the Stomach
Why might Aspiration Pneumonia occur?
Due to the backup of foodstuff in the Oesophagus potentially entering into the lungs
What does “No Aperistalsis (Achalasia)” refer to?
There are still Peristaltic Waves present, unlike in Achalasia
What symptoms would a patient with a Hypertensive present with?
- Odynophagia
- Chest Pain
- Heartburn
Why would the patient present with Odynophagia / Chest Pain?
Due to the increase in pressure within the Oesophagus
Why might the patient present with heartburn?
Due to the potentially underlying condition of GORD
What investigations are necessary in a Hypertensive Oesophagus?
- Upper G.I. Endoscopy
- Manometry
- A Barium Swallow
What is the function of the Upper G.I. Endoscopy?
To visualize the Oesophagus, ensuring there are no abnormal Growths
What is the function of the Manometry?
To measure the Pressure in the Distal Oesophagus
What is the function of the Barium Swallow?
To see the if there is any obstruction - this is outdated by Endoscopy
What shape would be seen in a Barium Swallow for someone with a Hypertensive (Nutcracker) Oesophagus?
A Corkscrew shape
