Oesophageal cancer and Achalasia

Question 1

Dysphagia Oesophageal cancer management CT chest/abdo or PET

Answer 1

reveals inoperable or metastatic disease

Question 2

Dysphagia Oesophageal cancer management endoscopic ultrasound

Answer 2

used to locoregional staging, is cancer intreamural or transmural.

Question 3

Dysphagia Oesophageal cancer management laparoscopy

Answer 3

used to eclude peritoneal deposits if there is no evidence of metastatic disease on CT/PET.

Question 4

Dysphagia Oesophageal cancer management surgery?

Answer 4

the definitive treatment for oesophageal cancer, patients will also receive adjuvant or neo-adjuvant chemotherapy.

Question 5

Risk factors of oesophageal cancer; squamous cell carcinoma?i

Answer 5

alcohol, smoking, dietary nitrosamines (pickled mouldy foods) and nitrates (Chinese, Iranian, South African diets), aaflatoxins, achalasia.

Question 6

Risk factors of oesophageal cancer; adenocarcinoma?

Answer 6

barretts Oesophagus, smoking, alcohol.

Question 7

Dysphagia Achalasia definition?

Answer 7

failure of relaxation of the lower oesophageal sphincter.

Question 8

Dysphagia Achalasia presentation?

Answer 8

young patient, no loss of weight, a long history of mild dysphagia to both solids and liquids with no problems coordinating the swallow in the mouth but feels that food/drink gets stuck on the way down to the stomach. Barium swallow will reveal a ‘bird’s beak’ pattern.

Question 9

Dysphagia achalasia treatment?

Answer 9

Treatments loosen the lower oesophageal sphincter but can’t restore peristalsis.

Question 10

Dysphagia achalasia main investigation?

Answer 10

Manometry distinguishes achalasia from other motility disorders.