GI - Esophagus Flashcards
-functional obstruction of the distal esophagus
-caused by incomplete relaxation of the LES, due to damaged esophageal nerves
-commonly affect middle age/older adults
Achalasia
What is the radiographic appearance of achalasia?
Upper GI w barium done
-gradual, tapered smooth 1-3cm narrowing of the distal esophagus
*widened mediastinum on CXR
Rat tail or bird beak appearance
-abnormal connection between the trachea and esophagus
-lack of development of the esophageal lumen resulting in a blind pouch (congenital esophageal atresia) ( orfice or passage is closed or absent)
Tracheoesophageal fistula (TEF)
What are the two types of tracheoesophageal fistulas?
Congenital
-most common
-developmental abnormality
-can be associated with other congenital abnormalities (Down syndrome, renal agenesis)
Acquired
-communication between trachea and esophagus caused by, surgery, cancer, trauma, infections
T/F
There a 4 types of congenital tracheoesophageal fistula (TEF)
*type 3 is the most common
And 1 type of acquired
True
*slide 16
-dilation of the submucosal veins
-caused by hypertension
-portal blood can not flow along normal path, instead must follow collateral route
-increase blood flow dilated veins
Esophageal varices
*bleeding is major complication
*result of cirrhosis in the liver
How does esophageal varices appear in imaging?
Wavy, thickened folds, appearing as round or oval filling defects
*rosary beads
*best demonstrated with barium swallow
-reflux of the stomach contents into the esophagus
-causes heartburn
-schincter muscles don’t close as well (LES)
*risk factors: alcohol, obesity, pregnancy, smoking
Gastroesophageal reflux disease (GERD)
How does GERD appear on an image?
*contrast studies are performed
-ulcers
-hazy appearance of wall
-stomach bulge into chest cavity through hiatus
-caused by: pressure in abdomen (obesity, pregnancy)
Hiatal hernia
What are the 2 types of hiatal hernias?
Sliding
-stomach and lower esophagus slide into chest through diaphragm
Paraesophageal
-esophagus and stomach stay where they are, but part of stomach squeezes through
-birth defect, hole is diaphragm
-organs in the abdomen can move through the hole and upwards into the baby’s chest
-can prevent the lungs for completely forming (breathing difficulties)
-can be difficult to diagnose neonatally, CXR shows organs in chest
Diaphragmatic hernia
*surgery is required
-occurs when tissues protrude through a weak spot in the abdominal muscles
-painful
-can become incarcerated (trapped/twisted) and strangulated (bowel tissue dies)
Inguinal hernia
Where is a foreign body most likely to be located?
Cervical esophagus and just above thoracic inlet and distal just above diaphragm
*lateral images are also taken to ensure the item is in the esophagus, not the trachea
-most are squamous cell type
-occur most often at the esophageal junction
-symptoms don’t usually appear until later stage
-poor prognosis
Esophageal carcinoma
How is esophageal carcinoma shown on a radiographic image?
Double contrast barium
-flat, plaque like lesions involving wall of lumen
-irregularities of wall
-mucosal destruction
-absent mucosal folds
