Esophagus Malignant Dz

Question 1

How much does the presence of Barrett esophagus increase the risk of developing adenocarcinoma?

Answer 1

50×

Question 2

What is the most common esophageal cancer?

Answer 2

Adenocarcinoma

Question 3

Where does adenocarcinoma of the esophagus usually occur?

Answer 3

Lower one-third of the esophagus

Question 4

Where does squamous cell carcinoma of the esophagus usually occur?

Answer 4

Upper two-thirds of the esophagus

Question 5

Most common presentation of esophageal cancer:

Answer 5

Dysphagia

Question 6

Complications of esophagectomy:

Answer 6

Bleeding, airway injury, insufficient conduit length, thoracic duct injury, respiratory (pneumonia), esophageal conduit necrosis, anastomotic leak, anastomotic stricture, hoarseness, chylothorax, transhiatal herniation of abdominal contents

Question 7

What are the characteristic findings of a chylous effusion?

Answer 7

Turbid, milky white fluid; specific gravity 1.020 to 1.030; protein content 3 to 4 g/100 mL; fat content 1 to 4 g/100 mL; triglyceride content >110 mg/dL

Question 8

What is the reported incidence of chylothorax as a complication of esophageal surgery?

Answer 8

∼4%

Question 9

Management for a chylous effusion with <500 cc/24 h chest tube output:

Answer 9

Nonoperative management (should stop spontaneously)

Question 10

Management for a chylous effusion with >500 cc but <1000 cc/24 h chest tube output:

Answer 10

Initially, nonoperative management; if not resolved or significantly improved in 5 to 7 days, perform operative duct ligation

Question 11

Management for a chylous effusion with >1000 cc/24 h chest tube output:

Answer 11

Early duct ligation