Oesophageal carcinoma

Question 1

In whom should oesophageal carcinoma be suspected?

Answer 1

Any middle-aged/elderly person with progressive dysphagia

Question 2

What features are seen in oesophageal carcinoma?

Answer 2

• Progressive dysphagia
• May have retrosternal pain (as result of local inflammation)
• Haematemesis
• ‘Alarm symps’ = weight loss, vomiting, anaemia
• Eventually = aphagia for both solids and liquids (high risk of aspiration pneumonia)

Question 3

What investigations are carried out in oesophageal carcinoma?

Answer 3

• Urgent endoscopy = inv of choice, allows visualisation and biopsy.
• FBC may show anaemia
• Barium swallow will show level of lesion, and characteristic stricture irregular in outline.

Question 4

What is the management of oesophageal carcinoma?

Answer 4

• Initially, ensure adequate hydration & nutrition.
• Curative surgery sometimes possible in lower part of oesophagus.
• In upper part = radiotherapy

Question 5

What is Barrett’s oesophagus?

Answer 5

• Metaplasia in oesophagus
• Normally lined with stratified squamous epithelium
• Changes into columnar epithelium
• Diagnosis via endoscopy and biopsy
• Pre-malignant