GIT: Esophagus Flashcards
describe esophgeal atresia
- non-canalization of portion of esophagus (atresia/stenosis)
esophageal atresia is commonly associated with ____
esophageal atresia is commonly associated with tracheo-esophageal fistula (TEF)
list the clinical symptoms of esophageal atresia
- clinical symptoms:
- excessive drooling of saliva
- aspiration pneumonia
- choking and cyanosis
describe esophageal webs and rings
protrusions of mucosa into the lumen
- upper esophagus = webs
- covered by squamous mucosa with vascularized core
- lower esophagus = Schatzi ring
- undersurface have columnar epi.
describe the triad seen in Plummer-Vinson syndrome (aka Kelly Patterson syndrome)
- triad:
- iron deficiency anemia
- esophageal webs
- atrophic glossitis
Plummer-Vinson syndrome has a high risk for ____
Plummer-Vinson syndrome has a high risk for squamous cell carcinoma of esophagus
patients with Plummer-Vinson sydrome present with ____ and ____
patients with Plummer-Vinson syndrome present with koilonychia (spoon nails) and splenomegaly (compensation for iron def.)
describe the treatment for Kelly Patterson syndrome
- treatment:
- iron
- endoscopic dilatation
list the 3 main features of achalasia/cardiospasm
- 3 main features:
- partial or incomplete relaxation of LES with swallowing
- aperistalsis
- increased resting tone of LES
one of the 2 primary causes of achalasia is the loss of _____ of the LES
one of the primary causes of achalasia is the loss of intrinsic inhibitory innervation of the LES
one of the primary causes of achalasia is the loss/absence of _____
one of the primary causes of achalasia is the loss/absence of ganglion cells in myenteric plexus
list the causes of secondary achalasia (pseduoachalasia)
- Chagas disease (Trypanosoma cruzi)
- diabetic autonomic neuropathy
- infiltrative disorders: malignancy, amyloidosis, sarcoidosis
- spinal motor neurons: polio, surgical ablation
- Down syndrome
- autoimmune disease
describe Mallory Weiss syndrome
- longitudinal mucosal tears at esophagogastric junction
- frequently in alcoholics after bout of severe retching
- inadequate relaxation of LES during vomiting
- hematemesis
- usually heals but sometimes fatal
in Mallory Weiss syndrome, there are ____ at the esophagogastric junction
in Mallory Weiss syndrome, there are longitudinal mucosal tears at the esophagogastric junction
Mallory Weiss syndrome is commonly seen in ___ after bouts of ____
Mallory Weiss syndrome is commonly seen in alcoholics after bouts of severe retching
in Mallory Weiss syndrome, there is inadequate ____ of the ____ during vomiting
in Mallory Weiss syndrome, there is inadequate relaxation of the LES during vomiting
list irritants that can cause esophagitis
- irritants:
- alcohol
- acids
- alkalis
list complications of reflux esophagitis
- complications:
- bleeding
- stricture
- aspiration pneumonitis
- Barrett esophagus & adenocarcinoma
describe the image
reflux esophagitis with scattered intraepithelial eosinophils and mild basal zone expansion
list 1 fungal and 2 viral causes of esophagitis
- fungal:
- Candida
- viral:
- Herpes simplex
- CMV
Barrett esophagus is replacement of esophageal ____ mucosa with metaplastic _____ with ____
Barrett esophagus is replacement of esophageal squamous mucosa with metaplastic columnar epithelium with goblet cells
Barrett’s esophagus leads to an increased risk for ____; the risk is related to ____
Barrett’s esophagus leads to an increased risk for adenocarcinoma; the risk is related to the length of Barrett’s mucusa
in Barrett’s esophagus screening with biopsy:
if there is no dysplasia, ____
if there is low grade dysplasia, ____
if there is high grade dysplasia, ____
if there is adenocarcinoma, _____
if there is no dysplasia, continue screening
if there is low-grade dysplasia, more frequent screening
if there is high-grade dysplasia, definitive therapy, resection or ablation
if there is adenocarcinoma, resection
esophageal varices are caused by dilated tortuous veins in the ___ and ___ of the lower esophagus (and prox. stomach) and is associated with ____
esophageal varices are caused by dilated tortuous veins in the mucosa and submucosa of the lower esophagus (and prox. stomach) and is associated with portal HTN
describe what is seen in the image
esophageal varices
describe what is seen in the image
esophageal varices
name diets that lead to higher risk of SCC
- diet
- vit. deficiency
- A, C, riboflavin, thiamine, pyridoxine
- fungal contamination
- high nitrite content
- vit. deficiency
list lifestyles that lead to a higher risk of SCC
- lifestyle:
- alcohol
- tobacco use
- HPV
list esophageal disorders that lead to a higher risk of SCC
- esophageal disorders:
- long-standing esophagitis
- achalasia
- Plummer-Vinson syndrome
list genetic changes that lead to higher risk for SCC
- genetics:
- Celiac disease
- ectodermal dysplasia (Tylosis)
____ is the precursor lesion for adenocarcinoma of the esophagus
Barrett’s esophagus is the precursor lesion for adenocarcinoma of the esophagus
