Esophageal Disorders Flashcards
Important cause of oropharyngeal dysphagia
Zencker’s diverticulum
Achalasia is often associated with…
Chaga’s disease
3 key points in pathogenesis of achalasia
- Progressive incoordination and absence of peristalsis
- Incomplete LES relaxation with swallowing
- Increased LES tone
X-ray sign of achalasia
Bird’s beak
Achalasia treatment
Smooth muscle relaxants, botox
If refractory, surgery (heller myotomy)
Treatment of esophageal varices (UGIB) (3)
- Pharmacotherapy to reduce portal HTN (somtostatin, ocreotide)
- Radiological therapy (shunting)
- Esophageal stenting & balloon tamponade
What is the progression of GERD to more serious complications?
prolonged GERD can lead to Barrett’s esophagus, which increases risk of esophageal adenocarcinoma
GERD treatment
Antacids, PPIs
GERD macroscopy vs microscopy
Macroscopy: Erythema/hyperemia, ulcers
Microsopy: NO intraepithelial eosinophils, elongated LP papillae, thickened BM
Eosinophilic esophagitis associated conditions
Asthma
Allergic rhinitis
Atopic dermatitis
Peripheral eosinophilia
Eosinophilic esophagitis treatment
Corticosteroids
Macroscopy eosinophilic esophagitis vs microscopy
Macroscopy: Feline trachealization
Microscopy: Presence of intraepithelial eosinophils
GERD vs eosinophilic esophagitis location
GERD: Distal esophagus
EE: entire esophagus
Barrett’s esophagus (definition + description)
Metaplasia of esophageal mucosa secondary to prolonged GERD.
Squamous cells of lower esophagus are replaced by intestinal epithelium (columnar, non-ciliated, goblet cells).
Barrett’s esophagus can progress to… therefore…
esophageal adenocarcinoma
therefore must follow-up with endoscopy
2 types of esophageal cancer
- Esophageal adenocarcinoma
- Squamous cell carcinoma
Esophageal cancer prognosis
Poor
Adenocarcinoma vs squamous cell carcinoma precursors
Adenocarcinoma: Barrett’s esophagus
Squamous cell carcinoma: Squamous cell carcinoma in situ
Adenocarcinoma vs squamous cell carcinoma risk factors
Adenocarcinoma: chronic GERD
Squamous cell carcinoma: smoking alcohol, 50yrs+, male, food carcinogens
Adenocarcinoma vs squamous cell carcinoma location
Adenocarcinoma: distal esophagus
Squamous cell: proximal 2/3
Which type of esophageal cancer is most common?
Adenocarcinoma
