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Systemic Pathology > Diseases Of The Oesophagus > Flashcards

Diseases Of The Oesophagus Flashcards

1
Q

What are some diseases of the esophagus

A

GERD/Barrett’s esophagus
Achalasia
Hiatal hernia
Diverticula
Webs/rings
Varices
Mallory Weiss syndrome

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2
Q

What are the triad in achalasia

A

Incomplete relaxation of the LES
Increases LES tore/pressure
Aperistalsis of the esophagus

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3
Q

What is the cause of achalasia

A

Damage to the inhibitory ganglion cells of the esophageal myenteric plexus

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4
Q

The primary cause of achalasia is ………..

A

Idiopathic

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5
Q

What is the disease cause of the secondary cause of achalasia

A

Chagas’ disease (caused by T. cruzi)

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6
Q

What is the etiology of Chagas’ disease

A

Destruction of the myenteric ganglion plexus cells of the GIT by T. cruzi

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7
Q

Which disease could cause injury to the vagal nerve

A

Diabetes mellitus

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8
Q

What is the presentation of achalasia

A

Dysphagia to both solids and liquids
Regurgitation
Retrosternal pain
Halitosis

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9
Q

How is achalasia diagnosed

A

Barium swallow
Manometry
CXR

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10
Q

What are the ways through which achalasia could be treated

A

Endoscopic pneumatic dilation
Heller myotomy
Pharmacological (nitrates, CCB, or botulinum)

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11
Q

What is hiatal hernia

A

The abnormal protrusion of a portion of the stomach into the thoracic cavity through a lac diaphragmatic hiatus

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12
Q

What are the risk factors of hiatal hernia

A

Advanced age
Smoking
Obesity
Pregnancy

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13
Q

What are the treatments for hiatal hernia

A

Lifestyle modifications
PPI
Surgery (hiatoplasty)

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14
Q

What are the two types of hiatal hernia

A

Sliding and rolling types

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15
Q

Describe sliding hiatal hernia

A

GE junction and the gastric cardia slide up into the post mediastinum (hourglass stomach). It associates with GERD and ulcerations

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16
Q

Describe the paraesophageal or rolling part of the gastric fundus

A

Part of the gastric fundus herniates into the thorax. GE junction stays in the anatomical position. It presents with early satiety and pain

17
Q

What is the most common type of esophageal diverticula

A

Zenker diverticulum

18
Q

Describe zenker diverticulum

A

A false diverticulum (outpouching) as it only contains the mucosa and submucosa

19
Q

Where does Zenker diverticulum occur

A

In the weak spot proximal to the upper esophageal sphincter (just above the cricopharyngeal muscle) in the Killian triangle (ie. pulsion type)

20
Q

What are some symptoms of an esophageal diverticulum

A

Dysphagia
Halitosis
Regurgitation
Retrosternal pain and pulmonary symptoms secondary to aspiration

21
Q

What are some other types of diverticula besides Zenker’s diverticula

A

Middle diverticulum (diverticulum at the trachea bifurcation. Traction type)
Lower diverticulum (epiphrenic diverticulum)

They are rare

22
Q

How are esophageal diverticula diagnosed

A

Barium swallowing or endoscopy

23
Q

What is the treatment for esophageal diverticula

A

Surgery

24
Q

What are esophageal webs

A

Thin protrusions of the esophageal mucosa into the lumen most often in the upper esophagus

25
Q

Which condition is associated with esophageal squamous cell carcinoma

A

Esophageal webs

26
Q

In what condition does esophageal webs occur in

A

Plummer- Vinson syndrome (severe iron deficiency anaemia, esophageal webs, atrophic glossitis)

27
Q

What are esophageal (Schatzki) rings

A

Circumferential narrowing of the lower esophagus. It can be congenital or acquired (Eg. congenital GERD)
Causes dysphagia or rarely complete obstruction of the esophagus

28
Q

Mention some pathogens or other causes that could cause esophagitis

A

Candida (white or yellow adherent plaques - pseudomembranes)
HSV-1
CMV
Chemical esophagitis (caused by ingestion of a string acid or base, alcohol, hot drinks or heavy smoking)
Medications (antibiotics or NSAIDs)
Eosinophilic esophagitis
Associated with atopy and allergic disorders (Eg. Food allergies)

29
Q

What are some presentations of esophagitis

A

Dysphagia
Heartburn
Food impaction

30
Q

What are esophageal varices

A

They are extremely dilated submucosal veins in the lower third of the esophagus (drained by the left gastric vein). Most commonly occurs as a consequence of portal hypertension (cirrhosis or portal vein thrombosis) and can lead to sudden onset of severe upper GI bleeding (hematemesis or melene) which could be fatal
Mallory Weiss syndrome (longitudinal linear laceration or tear in the mucosa at the GE at the lower oesophagus) could also cause it

31
Q

What is Mallory Weiss syndrome associated with

A

Forceful repeated vomiting (Eg. Alcohol and bulimia) can lead to painful acute upper GI bleeding and in extreme case to Boerhave syndrome (spontaneous rupture of the esophagus results in mediastinitis and subcutaneous emphysema)

32
Q

Esophagitis could manifest in immunocompromised patients
True or false

A

True

33
Q

Hourglass stomach is associated with what kind of condition

A

A sliding hiatal hernia

34
Q

What is Plummer-Vinson’s syndrome

A

Plummer-Vinson syndrome is defined by the classic triad of dysphagia, iron-deficiency anemia and esophageal webs

35
Q

What is Mallory-Weiss syndrome

A

A tear in the esophagus mostly found in the esophageal junction

Systemic Pathology (17 decks)

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