ESOPHAGEAL STRICTURE

Question 1

Pertinent Anatomy

Answer 1

Esophagus

Question 2

(1) Esophageal strictures are likely caused as a result to

Answer 2

esophageal irritation from chronic

GERD

Question 3

Approx. _____of cases of esophageal strictures are unrelated to gastroesophageal reflux,
and treatment in these cases may be more difficult. Examples include strictures
secondary to external beam radiation, esophageal sclerotherapy, caustic ingestions.

Answer 3

25%

Question 4

more commonly recognized cause of esophageal strictures, particularly in young men.

Answer 4

Eosinophilic esophagitis

Question 5

d. Signs and Symptoms

Answer 5

(1) Localized substernal chest pain
(2) Heartburn
(3) Dysphagia is the cardinal feature of esophageal stricture

Question 6

Differential Diagnosis

Answer 6

e. Differential Diagnosis
(1) GERD
(2) Esophageal Spasm
(3) Esophageal Dysmotility DisorderQ

Question 7

Lab

Answer 7

None

Question 8

RAD

Answer 8

(1) Endoscopy

(2) Barium study

Question 9

Treatment

Answer 9

(1) Mild symptoms- similar as GERD
(2) Severe symptoms- consider MEDEVAC for potential surgery
(3) Refer all patients for Dilation

Question 10

Initial Care

Answer 10

(1) For mild symptoms, treat patient as you would a patient with GERD.
(2) For more severe symptoms, such as dysphagia and asphyxiation
(a) Monitor patient, stabilize and consider MEDEVEC regardless of hemodynamic stability.
(b) Unresolved issue could lead to declining patient in a short period of time that would be in need of surgical intervention.
A

Question 11

Complications

Answer 11

(1) Mallory-Weiss Tear
(2) Asphyxiation
(3) Esophageal Paresis