Disorders of the oesophagus Flashcards
Cellular change occurring in Barrett’s oesophagus
Stratified squamous epithelium to simple columnar epithelium with goblet cells
Risk factors for Barrett’s oesophagus (4)
- Chronic GORD (5-15% develop)
- Obesity
- Male
- Age >50
Management of nondysplastic or low-grade oesophageal dysplasia
Annual endoscopy follow-up
Management of high-grade dysplasia or oesophageal adenocarcinoma
Endoscopic resection or radiofrequency ablation
Advanced cancer - surgery
Percentage of patients with Barrett’s who develop adenocarcinoma per year
0.5%
Risk factors for Mallory-Weiss tear (4)
- Alcoholism
- Bulimia nervosa
- Hiatus hernia
- NSAID abuse
Layers of oesophageal wall involved in Mallory-Weiss tear
Mucosa and submucosa only
Layers of oesophageal wall involved in Boerhaave syndrome
All layers, including muscular layer
Cause of eosinophilic oesophagitis
Food allergy
Histological appearance of eosinophilic oesophagitis
Dense infiltrate of eosinophils into the epithelial lining of the oesophagus
Features of eosinophilic oesophagitis on endoscopy and barium swallow
- Endoscopy - ridges, furrows, rings (corrugated/feline), white exudate
- Barium swallow - ringed/feline oesophagus
Gold standard diagnostic test for oesophageal achalasia
Oesophageal manometry (probe down the nose to measure muscle contractions during swallowing)
“Bird’s beak” or “rat’s tail” on barium swallow
Oesophageal achalasia
Definition of Hirschsprung’s disease
Achalasia of the rectum
Management of oesophageal achalasia (4)
- Sublingual nifedipine
- Botox injection
- Pneumatic dilatation
- Heller myotomy (dilatation + muscle cleavage)
Remember eating habits, post-op PPIs and frequent follow-ups
