oesophagus Flashcards
main symptoms involving the oesophagus
dysphasia (deficiency in speech generation)
odynophagia (pain swallowing)
heart burn
regurgitation
oesophagitis
inflammation of the oesophagus due to reflux
oesophagitis acute:
rare, corrosive following chemical ingestion
oesophagitis chronic
common, reflux disease
oesophagitis cause
reflux, defective sphincter (hiatus hernia) pregnancy (inc. intraabdominal pressure)
allergic oesophagitis incidence
male > female
allergic oesophagitis risk factor
history or family history of asthma
allergic oesophagitis histology
eosinophils, corrugated or spotty oesophagus
allergic oesophagitis treatment
steroids
chromoglycate
montelukast
barretts oesphagus
Metaplastic change where stratified squamous epithelium is replaced by columnar epithelium.
- Normally the squamous mucosa of the oesophagus and the columnar mucosa of the stomach meet at the Z line
barretts symptoms
largely as GORD but can be asymptomatic
barretts macroscopic appearance
red velvety mucosa in lower oesophagus
barretts complications
adenocarcinoma - this is a pre-malignant condition
barretts investigations
endoscopy shows epithelium change
biopsy to screen for cancer
barretts treatment
PPI and surveillance
what is more rare - benign or malignant cancer
benign
cancer symptoms
progressive dysphagia
weight loss - loss of appetite
chest pain
haematemesis
hoarse voice due to left recurrent laryngeal nerve invasion
cough due to trachea invasion
cancer paraneoplastic symptoms
hypercalcaemia
cancer investigations
endoscopy, biopsy barium swallow thorax/abdomen for CT staging US
squamous cell carcinoma caused
smoking, alcohol, HPV
which part of the oesophagus does SCC occur in
40% middle 15% lower
which part of the oesophagus does adenocarcinoma occur in
lower third - reflux greatest here
what does intermittent slow progression with a history of heart burn suggest
benign peptic stricture
what does relentless progression over a few weeks suggest
malignant stricture
