clinical overview gastro-oesophageal disease Flashcards
what are the three physiological constrictions of the oesophagus ?
cricopharynxgeus
aortic arch
hiatus
what is the lining of the oesophagus ?
stratified squamous epithelium
what is the general clinical presentation of oesophageal disorders ?
dysphagia with or without pain n
regurgitation/ drooling
malnutrition
what are the investigations for oesophageal disorders?
contrast radiology endoscopy and special tests such as: pH meter (GERD) Motility study (Achalasia)
what is the nature of the stricture of post corrosive oesophageal stricture ?
tight
long segment
multiple ( esoph, stomach)
marked proximal dilatation
what are the most common cases associated with PCOS ?
mostly children , with adults its mainly a suicidal attempt or a psychotic patient
what is the management for PCOS?
endoscopy after 2 weeks of insult then :
dilatation or resection
when do we perform a resection on a PCOS patient ?
if the dilatation failed
if there is a tight stricture
if there is a malignancy
when can we start considering a carcinoma with PCOS ?
if we performed dilatation and the patient still has dysphagia
what is achalasia ?
a motility disorder characterized by failure of relaxation of the lower oesophageal sphincter
what is the nature of the stricture in achalasia ?
distal ( less than LES)
short ( less than 5 cm)
smooth mucosa
centric lumen
what does the body of the oesophagus look like in achalasia ?
- enormous proximal dilatation with oesophageal fluid/air trap
- a-peristaltic
- absent gastric air bubble
what are the manometry results in achalasia ?
hypertesive and long LES
and no peristalsis
what does the position of the stricture indicate in achalasia ?
if its below the cupula of the diaphragm - most likely not carcinoma
above the cupula of the diaphragm- rat tail appearance (carcinoma)
what is the radiological finding with long standing achalasia ?
bird beak appearance (elongation and dilation)