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Surgery PLE > Esophagus > Flashcards

Esophagus Flashcards

1
Q

First diagnostic test in patients with suspected esophageal disease

A

barium swallow

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2
Q

Essential tool in preoperative evaluation of patients before antireflux surgery

A

manometry

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3
Q

Gold standard for diagnosis of GERD

A

24 hour ambulatory pH monitoring

96% specificity

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4
Q

Most specific symptom of foregut disease

A

dysphagia

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5
Q

Characteristics of defective sphincter

A
  1. LES with mean resting pressure of < 6 mmHg
  2. overall sphincter length of < 2 cm
  3. intraabdominal sphincter length of <1 cm
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6
Q

Grading of esophagitis

A

I - small circular nonconfluent erosion
II - linear erosion with granulation tissue, bleeds easily when touched
III - coalesce to form circumferential loss, cobble stone mucosa
IV - presence of stricture

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7
Q

Hallmark of barett esophagus

A

presence of intestinal goblet cells in the esophageal epitheliem (intestinal metaplasia)

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8
Q

Medical Management of GERD

A

12 weeks of emperic antacid

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9
Q

Surgical Management of GERD

A
  1. nissen fundoplication - 360 degree wrap
  2. belsey operation - 280 degree wrap
  3. hill operation - 180 degree wrap
  4. collis gastroplasty - esophageal lengthening
  5. angelchik prosthesis - placement of silastic device around the distal esophagus
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10
Q

Procedure for esophageal lengthening

A

collis gastroplasty

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11
Q

Procedure for placement of silastic device around the distal esophagus, keeping this segment in the abdomen

A

angelchik prosthesis

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12
Q

Type of hernia where there is upward dislocation of the CARDIA

A

Type 1

Sliding Hernia

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13
Q

Type of hernia where there is upward dislocation of the FUNDUS

A

Type 2

Rolling Hernia

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14
Q

A hernia that stretches the phrenoesophageal ligament

A

Type 1

Sliding Hernia

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15
Q

A hernia with a defect in the phrenoesophageal membrane

A

Type 2

Rolling Hernia

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16
Q

A hernia wherein the esophagogastric junction is in the mediastinum

A

Type 3

Mixed

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17
Q

A complication of hernia that is an emergency

A

Gastric volvulus

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18
Q

Triad of gastric volvulus

A

Borchardt’s triad

  1. pain
  2. nausea with inability to vomit
  3. inability to pass NGT
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19
Q

What is the diagnostic test for paraesophageal hernia

A

Barium esophagogram

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20
Q

It is a thin submucosal circumferential ring in the Lower esophagus at the squamocolumnar junction, often associated with hiatal hernia

A

Schatzki’s Ring

21
Q

Predominant feature of scleroderma of esophagus

A

atrophy of the smooth muscle

22
Q

This is the most common esophageal diverticulum

A

zenkers diverticulum

23
Q

This disease is due to weakness of the cricopharyngeal muscle at the KILLIAN’S AREA

A

zenkers diverticulum

24
Q

Treatment of zenkers diverticulum

A
  1. pharyngomyotomy: < 2 cm

2. diverticulectomy/diverticulopexy: >2 cm

25
Q

A disease characterized by complete absence of peristalsis in the esophageal body and failure of relaxation of LES

A

Achalaasia

26
Q

Triad of achalaasia

A
  1. weight loss
  2. regurgitation
  3. dysphagia
27
Q

treatment of achalasia

A

Heller’s Myotomy

28
Q

Characteristic feature of achalasia in barium esophagogram?

A

Dilated esophagus with a tapering

Bird’s Beak appearance

29
Q

This disease is seen in the esophagogram as corkscrew esophagus or pseudodiverticulosis

A

DES - diffuse and segmental esophageal spasm

30
Q

This is also known as supersqueezer esophagus

A

nutcracker esophagus

31
Q

This is a puslion diverticula

A

Epiphrenic diverticula
False Diverticula
Cause: Motor Disorder

32
Q

This is a traction diverticula

A

Midesophageal Diverticula
True Diverticula
Cause: Inflammatory disorder

33
Q

A disease with spontaneous perforation of the esophagus

A

Boerhaave;s syndrome

post emetic esophageal rupture

34
Q

Treamtent of esophageal perforation

A

primary closure of the perforation within 24 hours results in 80 - 90% survival

35
Q

Most common location of esophageal perforation

A

left lateral wall of esophagus, just above the GEJ

36
Q

This disease is characterized as longitudinal tear in the mucosa of the GE junction

A

Mallory weiss syndrome

37
Q

Phases of caustic injury

A
  1. acute necrotic phase
  2. ulceration and granulation phase
  3. cicatrization and scarring
38
Q

The phase of caustic injury where in the esophagus is weakest

A

ulceration and granulation phase

39
Q

This phase of caustic injury is characterize by dysphagia

A

Cicatrizaation and scarring

40
Q

Diagnostic test for caustic injury

A

Esophagogram within 12 hours

41
Q

Most common presenting symptom of esophageal carcinoma

A

dysphagia

42
Q

Characteristic of cervical esophagus carcinoma

A
  1. squamous
  2. unresectable
  3. invades larynx, trachea, great vessels
43
Q

treatment of cervical esophagus carcinoma

A

Stereotactic radiation with concomitant chemotherapy

44
Q

Characteristic of thoracic esophagus carcinoma

A
  1. squamous

2. lymph node metastasis

45
Q

treatment of thoracic esophagus carcinoma

A

VATS + thoracotomy

46
Q

Characteristic of distal esophagus carcinoma

A
  1. adenocarcinoma
47
Q

treatment of distal esophagus carcinoma

A

curative resection requires cervical division of esophagus + >50% gastrectomy

48
Q

It is a procedure for middle/thoracic esophageal lesion wherein all the LN are removed en bloc with the lesser curvature of the stomach

A

Ivor Lewis Procedure

49
Q

This surgical procedure is excellent in exposure of the distal esophagus

A

Left thoracoabdominal approach

Surgery PLE (16 decks)

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