Esophagus, Stomach Flashcards
Recommended anti reflux procedure
Nissen fundoplocation
Most common diaphragmatic hernia invovles?
Upward dislocation of the cardia to the thorax; aka sliding/type I
Diaphragmatic hernia: upward dislocation of the fundus
II
Combined herniation of cardia and fundus
Mixed/ type 3
Additional organ herniates aside from stomach
Type IV
Cheat pain, retching, inability to vomit, inability to pass NGT
Borchardt’s triad
Zenker’s diverticulum
Pharyngoesophageal
Diverticula that contains mucosa and submucosa
False
Results from high pressure generated in the hypopharynx
zenker’s diverticula
Area of potential weakness situated behind the esophagus at the level of te cricopharyngeus muscle
Killian’s triangle
Dx for diverticula
Barium swallow
Tx for zenker
2 cm or less- pharyngomyotomy;
>2cms- diverticulectomy
Diverticulopexy
Diverticula located 5cms above and below the level of the carina
Mid thoracic
Heller’s myotomy is used for
Achalaska
Most common primary esophageal disorder
Nutcracker esophagus
Spontanoeus rupture of esophagus; hx of resisting vomiting
Boerhave’s syndrome
Ivor lewis procedure is for
Esophageal carcinoma
Oringer ‘s trans hiatal technique is for
Esphophageal carcinoma
Akiyama technique is fir
Esohageal carcinoma(left thoracoabdiminal approach)
Submucosal ring in lower esophagus
Schatzki’s ring
Dysphagia atrophic oral mucosa, spoon shaped fingers with brittle nails, chronic anemia
Plummer vinson syndrome
Mucosal tears located at the GE junction
Mallory weis tear
Gives criminal nerve of Grassi
Right vagal trunk
Preferred for confirming cure in PUD
Urea breath test
Most common gastric ulcer type
I: antral lesser curvature
NSAID induced gastric ulcer type
V
Type of gastric ulcer associated with acid hypersecretion
II and III(type I plus duodenal ulcer; pre pyloric ulcer)
Aka graham’s procedure
Omental patching
Gastroduodenostomy
Bilroth I
Gastrojejunostomy
Billroth II
Drainage procedure in peptic ulcer
Heineke Mikulicz pyloroplasty
Medical management for early dumping
Octreotide
Medical management for late dumping
Alpha glucosidase inhibitor
Surgical management for dumping
Roux en Y anastamosis
ZES involves uncontrolled secretion kf
Gastrib
Confrmatory test for ZES
Secretin stimulaion tets
Most common malignant neoplasm of stomach
Adenocarcinoma
Gold standard in diagnosing gastic carcinoma
Upper endoscopy + biopsy
Mgmt for gastric adenocarcinoma
Resection of all tumor(R0) with 5cms grossly negative margins (radical subtotal gastrectomy)
Most common site for primary gastric GI lymphoma
Gastric lymphoma
Mgmt for gastric lymphoma
Chemo; radical subtotoal gastrectomy for tumor complications
GIST tumor marker
C KIT
Mgmt for GIST
Wedge resection with negative margins; imatinib for unresectable
Arise from gastric ECL cells
Gastric carcinoid
Most common type of gastric carcinoid
I
Mgmt for gastric carcinoid
Small: EMR(endoscopic mucosal resection); larger: radical subtotal gastrectomy
Also called Menetrier’s disease
Hypertrophic gastropathy
Associated with protein losing enteropathy and hypochlorydia
Menetrier’s disease
Aka watermelon stomach
Gastric antral vascular ectasia
Dilated mucosal blood vessel in distal stomach
watermelon stomach
Cogenital AV malformation; unusually large tortuos submucosal artery
Dieulafoy’a lesion
Mgmt for dieulafoy
Endoscopic hemostasis, angiographic embolization, oversew or resection
3 areas of narrowing
Cricopharyngrus, left mainstem bronchus, diaphragmstic hiatus
