Oesophagus Flashcards
Describe GORD findings on biopsy
Basal cell hyperplasia
Protrusion of rete pegs
How can you prove a patient has oesophageal atresia?
Failure to pass an NG tube
CXR shows air contrast in upper oesophageal segment
- How to diagnose a H-type tracheoesophageal fistula
- How may they present?
- Does it show on oesophagraphy? Y/N
Methylene blue at bronchoscopy
Young patients, recurrent aspirations
Doesn’t show on oesophagraphy
Is it common to get dysmotility (dysphasia) after oesophageal atresia repair? Y/N
What other congenital abnormalities are associated with oesophageal atresia?
- Yes
2. VACTERL vertebral Anal Cardiac Tracheal Esophageal Renal Limbs
Describe what a duplication cyst is
Congenital anomaly, fluid filled an-echoic submucosal lesion
What is the management of an oesophageal ring?
50 French mercury-weighted dilator
Managemt in achalasis
Hellor myotomy
Botox
Pneumatic dilatation
When does a Schiatzki ring become symptomatic
13mm
What is the treatment for Schatzki ring?
Dilatation if dysphasia
PPI to prevent recurrence
Signs and symptoms of Plummer-Vinson syndrome?
Fe deficiency Dysphagia Oesophageal web (thin horizontal membrane protruding from anterior wall)
What can cause vascular compression of the oesophagus?
Abbeeant right subclavian (pencil like indentation @ T4
Why does a CVA cause dysphagia?
Affects skeletal muscle
Difficulty initiating swallowing
(The distal 50% of the oesophagus is smooth muscle)
Describe pharyngeal closure
Nasopharyngeal closure by elevation and retraction of soft palate = upper oesophageal sphincter opens = laryngeal closure = tongue loading and pulsion = pharyngeal clearance
Describe the cause of achalasis
Loss of ganglion cells in myenteric plexus
Describe the manometry findings of achalasia
- relaxation pressure >10mmHg (RAISED)
- aperistalsis
What test is the most sensitive for local staging of oesophageal cancer
EUS
Manometry findings of diffuse oesophageal spasm
Normal LOS relaxation
LOS pressure varied
Loss of sequential oesophageal peristalsis with stimulus high amplitude contractions in >10% swallows
Manometry findings of hypertensive lower oesophageal sphincter
High LOS pressure
Normal peristalsis and LOS relaxation
Manometry findings of nutcracker oesophagus
Normal peristalsis, but high amplitude contractions (>180mmHg)
Manometry findings of achalasia
LOS relaxation incomplete
LOS testing pressure high
Aperistalsis
