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Surgery 1 > Esophageal And Mediastinal Diseases > Flashcards

Esophageal And Mediastinal Diseases Flashcards

1
Q

Explain Esophageal manometry?

A

Test that evaluates motility and function of LES and UES

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2
Q

What is Achalasia?

A

The failure of LES relaxation when swallowing

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3
Q

Achalasia investigations?

A

Endoscopy and Barium swallow

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4
Q

Medical management of Achalasia?

A

Nitrates to relax the LES

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5
Q

What does Botulinum toxin do to treat Achalasia?

A

Weakens the LES when injected into it

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6
Q

What is the surgical treatment for Achalasia SHOULD, balloon dilation fail.

A

Esophagocardiomyotomy (Heller Myotomy )

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7
Q

What should we do to treat Achalasia, should the Heller procedure fail?

A

Esophageal resection and reconstruction

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8
Q

First line treatment for Esophagitis?

A

Oral and parental broad spectrum antibiotics

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9
Q

In Esophagitis, what do we give to relive Laryngeal edema?

A

Corticosteroids

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10
Q

How do we treat First Degree burn esophagitis?

A

Continue Antibiotics for 10 Days.

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11
Q

How do we treat Second/Third Degree burn esophagitis?

A

Install silicon catheter down esophagus for feeding, until the patient heels, which takes 1-4 months.

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12
Q

What is the surgical resection procedure for Esophageal cancer?

A

Esophagectomy with gastric pull up

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13
Q

What is Barrett’s esophagus?

A

The lining of lower esophagus with columnar epithelium

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14
Q

How to diagnose Barrett’s esophagus?

A

Endoscopy

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15
Q

What is Barrett’s believed to result from?

A

Chronic GERD

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16
Q

What is Barrett’s importance?

A

Predisposes to esophageal cancer

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17
Q

How is Barrett’s treated?

A

Control the GERD

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18
Q

Where does Squamous cell carcinoma arise?

A

Upper and middle thirds. For black people

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19
Q

Where does Adenocarcinoma arise?

A

In the Lower third. Predominantly white males

20
Q

Esophageal tumors are are diagnosed via?

A

Barium swallow initially, then confirmed is endoscopy or biopsy

21
Q

How do we assess esophageal cancer staging?

A

Via endoscopic ultrasonography

22
Q

What’s the approach for tumor resection?

A

Right or left thoracotomy

23
Q

Which esophageal tumor could be treated via radiotherapy, should resection fail?

A

Squamous cell carcinoma

24
Q

What is Barrett’s esophagus believed to pre-dispose?

A

adenocarcinoma

25
Q

Clinical features of GERD?

A

Heart burn, regurgitation

26
Q

GERD treatment generally, and surgical

A

Lifestyle modification, Fundoplication

27
Q

What is the indication to do surgery for GERD?

A

When medical therapy (more than 6 months) fails.

28
Q

What is the approach for Nissen Fundoplication

A

Trans-abdominal

29
Q

What is an Esophageal Diverticulae?

A

A sack or pouch protruding from the esophagus, like a ball sack

30
Q

Esophageal divertiucalae treatment?

A

Larger ones are excised, Cricopharyngeal myotomy is essential

31
Q

What is a Hiatal Hernia?

A

An abdominal protrusion into the esophagus, from the stomach

32
Q

Most common type of Hiatal Hernia?

A

Sliding hernia I.e Type 1

33
Q

Commonest sign of Hiatal Hernia?

A

Regurgitation obviously, due to the hernia being there

34
Q

How do we know if the hernia is para-esophageal?

A

Chest X-ray confirms its position

35
Q

Surgical treatment of para-esophageal hernia?

A

Fundoplication

36
Q

What is the most common tumor of the anterior mediastinum?

A

Thymoma

37
Q

Thymoma treatment if stages 1/2?

A

Total resection

38
Q

Thymoma treatment if stage 3

A

Resection and post op chemotherapy

39
Q

Thymoma treatment if stage 4a and b?

A

Chemo

40
Q

How do we treat Pericardial cysts?

A

Percutaneous drainage and resection

41
Q

How do we treat an enteric cyst?

A

Resection

42
Q

How do we treat mediastinitis?

A

Surgical debridement

43
Q

Where do we find teratomas?

A

Anterior mediastinum

44
Q

What is a rare cause of posterior mediastinal mass?

A

Meningocele

45
Q

What is Collis Gastroplasty?

A

The lengthening of the esophagus, done for GERD in case of short esophagus.

46
Q

Complications of Anti-Reflux surgery?

A

Technical failures, dysphagia (difficulty swallowing)

Surgery 1 (28 decks)

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