Diseases of Esophagus Flashcards
1
Q
sensation of impaired passage of food or liquids from mouth the stomach
A
DYSPHAGIA
2
Q
- painful swallowing
- Ranges from a dull ache to stabbing pain
- Usually represents a severe inflammatory process.
- Rarely associated with severe GERD or malignancy
A
ODYNOPHAGIA
3
Q
- substernal discomfort
- Can mimic cardiac disease (e.g., can radiate to the arm or jaw) (need to rule it out)
A
CHEST PAIN
4
Q
- Difficulty transferring food from the mouth to the upper esophageal sphincter
- Neurological disorders
CVAs (brainstem), Parkinson’s, Motility - Anatomic
Neoplasms, Zenker’s diverticulum
A
OROPHARYNGEAL DYSPHAGIA
5
Q
Difficulty with the passage of ingested material from the hypopharynx to the stomach
Neuromuscular
- Diffuse esophageal spasm, Achalasia, Scleroderma
Obstructive lesions
- Strictures, rings, foreign body, carcinoma
A
ESOPHAGEAL DYSPHAGIA
6
Q
- outpouching in oropharyngeal/upper GI region
- main symptom: Dysphagia
- ~85% occur in individuals >50 years old
- Diverticulum can be large enough retain food which can result in fullness or gurgling in the neck, coughing or aspiration, regurgitation of retained food, obstructive symptoms by compression
- requires surgical intervention
A
ZENKER’S DIVERTICULA
7
Q
- Failure of relaxation of lower esophageal sphincter due to loss of myenteric/Auerbach’s plexus
- main symptom: Dysphagia
- distal esophageal sphincter is closed; above the sphincter, the esophagus is dilated b/c can’t push food past the sphincter –> “Bird’s Beak esophagus”
- Insidious, with progressive dysphagia to solids first, then liquids
- TRIAD OF FINDINGS: Increased LES resting pressure; Inability of the LES to relax; Absence of peristalsis in body of the esophagus
A
Achalasia
8
Q
- fibrous tissue that is inside the esophagus that disrupts things coming through (dysphagia)
- “steakhouse syndrome”: Not an emergency, b/c you think you can pass it
- If you have stuff staying in the esophagus for too long, you can eventually tear it
A
Schatzki’s ring
9
Q
- Most commonly Candida (white pseudomembrane); can also be herpes (punched-out ulcers) or CMV (linear ulcers)
- person had infection of lining of the esophagus, causing pain (odynophagia)
- Affects HIV patients, steroids, chemotherapy, diabetes
A
Esophagitis
10
Q
- mucosal injury commonly due to: doxycycline, iron, potassium, vitamin C, quinidine, aspirin, NSAIDs, alendronate
- Main symptom: Odynophagia
- looks like huge ulcer with clot
- resolves when cease taking medication
A
MEDICATION-INDUCED ESOPHAGITIS
11
Q
- appears as “corkscrew” esophagus; sequeezing, w/o normal peristalsis
- Primary symptom: chest pain
- due to: Acid reflux into esophagus, which irritates the lining and causes spasm & pain, or may be due to heart condition
A
Diffuse esophageal spasm
12
Q
- Constellation of symptoms and/or the presence of esophageal tissue damage due to the reflux of gastric contents into the esophagus
- primary offensive factor is acid
- Common abnormalities: LES incompetence, Anatomic disruption of relationship between LES and diaphragm (sliding hiatal hernia), or Increased intraabdominal pressure (obesity, pregnancy)
- TYPICAL SYMPTOMS: Substernal discomfort, burning irritation (“heartburn”); Regurgitation
- ATYPICAL AND EXTRAESOHPAGEAL SYMPTOMS: Dysphagia (from inflammation or scarring), Non-cardiac chest pain; Throat discomfort, hoarseness; Coughing, wheezing, bronchospasm; Gingivitis, poor dentition
- Poor correlation between heartburn severity and degree of esophagitis
A
Gastroesophageal Reflux Disease
13
Q
- Primary role is to determine evidence of tissue injury and/or the presence of Barrett’s epithelium
- Used when there is dysphagia or evidence of bleeding
A
Endoscopy
14
Q
- useful when there is doubt about symptom etiology; atypical symptoms
- monitoring medication effects
- pre-operative evaluation
A
pH monitoring
15
Q
- Useful to assess presence of a motility disorder
- Performed as a pre-operative assessment
A
ESOPHAGEAL MANOMETRY
