Esophagus/Stomach Pathologies Flashcards
What is a Tracheoesophageal Fistula?
Congenital or acquired communication between the trachea and esophagus
- Can be acquired from malignancy, infection, trauma
- often lead to severe and fatal pulmonary complications (aspiration pneumonia)
Symptoms include coughing, choking when eating, and difficulty breathing. Can lead to pulmonary complications.
What is the radiographic appearance of Tracheoesophageal Fistula?
Radiographic imaging with contrast media shows contrast outlining the areas with esophageal communication.
What is Esophageal Atresia?
Failure of the esophagus to develop as a continuous passage, ending in a blind pouch
- Immediate surgery is required to repair the esophagus (to prevent starvation)
Often requires immediate surgery to prevent starvation.
How does Esophageal Atresia appear radiographically?
Radiographic imaging with contrast media shows the esophagus ending abruptly.
What is Gastroesophageal Reflux Disease (GERD)?
Broad term for any type of reflux of the stomach contents into the esophagus.
- seen with hiatal hernia
- Develops when the lower esophageal sphincter does not work properly
What are the symptoms of GERD?
Causes reflux esophagitis, superficial ulcerations, and burning chest pain.
How is GERD demonstrated radiographically?
Demonstrated by a barium study of the esophagus, usually double contrast. (barium & air/CO2)
What is Dysphagia?
Difficulty swallowing.
Radiographically - Structural abnormalities, masses, barium
not getting swallowed as normal on
barium swallow
What is Esophageal Carcinoma?
Cancer of the esophagus, most common site is the esophagogastric junction.
- strongly related to smoking and alcohol
How does Esophageal Carcinoma appear on a barium swallow?
Flat plaque-like lesions with central ulceration, irregularity in the esophageal wall.
- CT is best for staging
What is Zenker’s Diverticulum?
Pharyngo-esophageal: pouch that can trap food and liquid.
Diverticula: small, bulging pouches that can form in the lining of your digestive system
What are the symptoms of Zenker’s Diverticulum?
Difficulty swallowing and chronic cough.
How is Zenker’s Diverticulum seen radiographically?
Seen on a barium swallow as a sac that fills with barium posteriorly.
What are Esophageal Varices?
Dilated veins in the wall of the esophagus due to portal hypertension.
What is the radiographic appearance of Esophageal Varices?
Double contrast barium swallow shows serpiginous thickening of folds.
What is a Hiatal Hernia?
Acquired anatomical abnormality where part of the stomach protrudes through the diaphragm.
- Can cause stomach acid in esophagus and related esophagitis, ulcers
- negligible and asymptomatic
What are the symptoms of a Hiatal Hernia?
May cause heartburn and shortness of breath.
How is a Hiatal Hernia demonstrated radiographically?
Can see part of stomach above sphincter on S&D.
- Large hiatal hernia may be demonstrated
on CXR as soft tissue mass with air fluid
level
What is a Diaphragmatic Hernia (Congenital)?
Abnormal development of the diaphragm allowing abdominal contents to protrude into the chest.
What is a Diaphragmatic Hernia (Acquired)?
Associated with trauma where abdominal organs can prolapse into the thoracic cavity.
What is Achalasia?
Functional obstruction of the distal section of the esophagus.
- Proximal dilation caused by incomplete
relaxation of the lower esophageal sphincter
What does a barium study show in Achalasia?
Demonstrates progressively dilated esophagus with narrowing at distal end.
Image from top of nasopharynx to anus in young children to include all GI tract (and chest) - May be done all in one image
What are Foreign Bodies in the GI area?
Aspirated, ingested or penetrated items.
What should be considered when identifying Foreign Bodies?
Determine if it is IN or ON the patient.
