Esophogeal Disorders

Question 1

2 types of esophageal movement

Answer 1

Peristalsis= moves food forward
Segmental= mixing

Question 2

Achalasia

Answer 2

Incomplete relaxation of lower sphincter during swallowing leading to functional obstruction and proximal dilatation
Ganglion cells of the myenteric plexus are diminished or absent
Histology: Inflammation in the area of M. plexus
Hypotheses: autoimmune, viral infections
5% develop squamous cell carcinoma

Question 3

Achalasia Imaging Studies

Answer 3

UGI: Bird’s Beak.
EGD: Normal or dilated esophagus.
Manometry

The radiologic examination of choice is a barium swallow study performed under fluoroscopic guidance.

Question 4

Esophageal Atresia

Answer 4

congenital abnormality in which the mid portion of the esophagus is absent
Absence of gas in the abdomen suggests that the patient has either atresia without a fistula or atresia with a proximal fistula only

Question 5

Barrett’s Esophagus

Answer 5

Acid damages lining of esophagus and causes chronic esophagitis
Damaged area heals in a metaplastic process and abnormal columnar cells replace squamous cells
This specialized intestinal metaplasia can progress to dysplasia and adenocarcinoma

Question 6

Mallory-Weiss tear

Answer 6

Caused by severe retching and vomiting
Tear occurs at the junction of the esophagus and stomach
ER from alcoholics

Question 7

Esophageal varicies

Answer 7

Usually secondary to portal hypertension and cirrhosis of the liver
Anything that increase pressure i.e. coughing can start massive bleed

Question 8

Most common of esophageal diverticulum

Answer 8

Zenker’s diverticulum
Saclike outpouching of one or more layers of the esophagus
Located above the upper esophageal sphincter