16. Upper GI Flashcards
What kind of epithelium is found in the oesophagus?
Squamous
What are the layers of the oesophagus?
Mucosa
Submucosa
Circular and longitudal muscle
Adventitia
Name a developmental disorder of the oesophagus
Atresia
Fistula between trachea and oesophagus
What is the difference between a true and false diverticula?
True involves all 4 layers
False only involves the mucosa and submucosa
What are webs and rings?
Webs are mucosal folds
Rings are made of mucosa and submucosa, fibrosis over time
What are the 2 types of hiatus hernias?
Sliding and paraoesophageal
What are the features of achalasia?
No peristalsis
LOS doesn’t relax when swallowing
What are the secondary causes of achalasia?
Trypanosoma, polio
Tumour, amyloidosis, sarcoidosis
How can the oesophagus be perforated?
Severe vomiting
Instruments
What is a longitudinal tear in the oesophagus known as?
Mallory-Weiss
What complication is associated with perforated oesophagus?
Mediastinitis
What are the infective causes of oesophagitis?
Candida, herpes, CMV
What are the physical causes of oesophagitis?
Irradiation
Hot liquids
Reflux
What are the signs of reflux on histology?
Basal cell hyperplasia
Eosinophils
Long lamina propia papillae
What is barret’s oesophagus?
Metaplasia of the lower oesophagus from squamous to glandular epithelium
Always in lower 1/3
What type of tumour does barret’s increase the risk of?
Adenocarcinoma
What benign tumours can be found in the oesophagus?
Leiomyomas
Lipoma
Fibroma
How is a tumour diagnosed in the oesophagus?
Barium swallow
Endoscopy
Biopsy
What are the causes of reflux?
Increased abdominal pressure
Hiatus hernia
Smoking and alcohol
What part of the oesophagus are squamous cell carcinomas found in?
Mid 1/3
What are the risk factors for squamous cell carcinoma in the oesophagus?
Alcohol, smoking, vitamin deficiencies, high nitrites in diet
Achalasia, long standing oesophagitis, coeliac disease
Plummer-Vinson syndrome
What is Plummer Vinson syndrome?
Iron deficiency, webs and glossitis
What are the causes of acute gastritis?
Alcohol and smoking
NSAIDs and steroids
Shock
Irradiation
What are important features in the history of a patient with acute gastritis?
Haematemesis
Malaena