Esophagial disorders Flashcards
IOC in management of GERD unresponsive to Rx
Ambulatory esophagial pH monitoring
Cancer associated with Baretts
Adenocarcinoma
Gold standard inv for achlasia
Esophagial manometry
Gastric varice with highest tendency to bleed
IGV1
Cause of secondary achlasia
Trypanosoma Cruzi
Chagas disease
Predictive factors of variceal hemorrhage
Size of varice- most important
Variceal pressure
Location of varices -GE junction
Appearance of varices- Red signs, red wale mark
Cinical features of patient- Child Pugh score
Risk factor with greatest impact on development of esophagial cancer
Barretts esophagus
Others- alcohol, smoking,high socioeconomic status
Surveillance of Barrett’s esophagus
Repeat scope in 12mon post diag- ensure no dysplasia
No dysplasia on Bx in 2 scopes- 3 yrly scope, high dose PPI
Low grade dysplasia -1yrly scope
High grade dysplasia -Surgical resection if medically fit
Others - 3 monthly scope surveillance or endoscopic ablation
Condition associated with CAG A negative H Pylori
Gastric ulcer
CAG A Positive H Pylori - associated with duodenal ulcer
Manometric feature most characteristic of Achalasia
High resting tone of LES
Other- failure of LES to relax with swallowing
Dimnished or absent peristalsis in esophagial body
Most common precipitant of esophagial SCC
Smoking
Barretts predisposes to adenocarcinoma
Barretts esophagus management
Mucosal ablation+ high dose acid suppression
Features of eosinophilic esophagitis
Often young males presenting with dysphagia, food impaction
Associated with asthma,atopy
Exudates, rings, furrows, tears on dilatation
Biopsy -25 Eo/hpf
Mx of eosinophilic esophagitis
PPI
Topical steroids -budesonide
Dilatation in c/o submucosal fibrosis
Elimination diet -wheat, milk,eggs,nuts,seafood,soy
Barium swallow in Achlasia
Rat tail appearance
