Esophageal

Question 1

MCC boerhaave?

Answer 1

instrumentation

Question 2

diagnostic test for boerhaave? how to eleminate false negative testing?

Answer 2

contrast esophagram/right lateral decubitus

Question 3

best contrast to test for rupture?

Answer 3

gastrograffin better than barium because barium more irritating to the mediastinum

Question 4

paroxysmal coughing and choking in a patient with chemoradiation tx for SCC?

Answer 4

TE fistula

Question 5

diagnose TE fisula?

Answer 5

barium swallow

Question 6

treatment for mallory weiss?

Answer 6

decompress stomach and if no spontaneous resolution consider EGD with epi injection

Question 7

imaging findings that make it ok to treat esophageal perf constervatively?

Answer 7

contained within mediasinum and drains back into esophagus

Question 8

conservative tx for esophageal perf?

Answer 8

TPN, abx, H2 blocker attempt feeding after 7-10 d

Question 9

bad perforation surgery options?

Answer 9

nissen fundoplication or myomotomy

Question 10

isolated gastric veins cause?

Answer 10

left sided portal HTN from splenic vein thrombosis

Question 11

most common cause of splenic vein thrombosis?

Answer 11

pacreatic disease

Question 12

splenic vein thrombosis causes increase pressure in what vessels?

Answer 12

short gastric veins supplying the fundus

Question 13

tx for isolated gastric veins from splenic vein thrombosis?

Answer 13

splenectomy

Question 14

benefits of abx in esophageal bleed?

Answer 14

reduce all cause mortality, infection related mortality, rebleeding and LOS

Question 15

first tests for caustic injury to the esophagus?

Answer 15

esophagram and endoscopy