Esophageal Pathology Flashcards
What are general signs and symptoms of a GI pathology?
Dysphagia
Chest pain
Abdominal pain
Changes in eating/bowel habits
Icterus (Jaundice)
What quadrant is the ascending colon in?
RLQ
What is an atresia?
Incomplete failure of a vessel to form
What is a fistula?
Abnormal communication between two vessels
What is the main clinical feature in a patient with an esophageal atresia?
Vomiting upon first feeding almost immediately
What is the main clinical feature in a patient with a tracheoesophageal fistula?
Aspiration pneumonia or choking upon first feeding
What are esophageal diverticula?
Outpuchings of the esophagus
What is a Zenker diverticulum?
Esophageal diverticula located above the upper esophageal sphincter
What is the main symptom in a patient with a Zenker diverticulum?
Chronic fetid halitosis (ass breath)
What is a traction diverticulum also called?
Epiphrenic diverticulum
What is a traction or epiphrenic diverticulum?
Esophageal diverticula located above the lower esophageal sphincter but below the upper esophageal sphincter
Patient presents to your office complaining that no one will talk to him at work. You immediately recognize that his breath is putrid. You order a barium swallow just to get this guy out of your office ASAP. Barium swallow shows a pouch posteriorly on the esophagus above the upper esophageal sphincter. What is the likely diagnosis?
Zenker diverticulum
Zenker’s diverticulum occurs (Above/Below) the upper esophageal sphincter?
Above
What is the most common location of intestinal diverticulosis?
Sigmoid colon
Traction/Epiphrenic diverticulum occurs (Above/Below) the upper esophageal sphincter?
Below
What is an esophageal web/ring?
Concentric, smooth, thin extension of normal esophageal tissue
Where is an esophageal web/ring most common?
Distal esophagus
What is an esophageal web/ring called when it is at the gastroesophageal junction?
Schatzki ring
What is a Schatzki ring?
Narrowing of the lower esophagus due to an esophageal web/ring at the gastroesophageal junction
What syndrome is an esophageal web/ring often associated with?
Plummer-Vinson syndrome
25 year old male patient presents to your office complaining of occasionally having difficulty swallowing. Notable in the patients history is a severe form of iron deficiency anemia. A barium swallow of the esophagus is ordered. Imaging shows a thinning of the esophagus due to a muscular band at the gastroesophageal junction. What is the likely diagnosis? What syndrome is this patient co-presenting with?
Schatzki ring; Plummer-Vinson syndrome
What is esophageal achalasia?
Failure of the lower esophageal sphincter to relax with swallowing with absence of peristalsis in the upper esophagus
How does esophageal achalasia occur?
Loss of or absence of ganglion cells in the esophageal myenteric plexus
How will esophageal achalasia present on a radiograph?
Rat’s tail or “bird-beak” deformity
MEGA-ESOPHAGUS is associated with what pathology?
Esophageal achalasia
What is a treatment modality for an esophageal achalasia?
Nitroglycerin to relax the lower esophageal sphincter (smooth muscle relaxer)
At a business dinner amongst fellow doctors you notice one of your colleagues consistently going to the bathroom after a few bites of his steak. After the third time, you ask him why he keeps going to the bathroom. He explains his condition to you without naming it. Stating that he has trouble holding down food and pain upon swallowing. He details a recent barium swallow stating that his esophagus looked like a birds beak. What is the likely condition that this person possesses?
Esophageal achalasia
What is scleroderma also known as?
Progressive Systemic Sclerosis