Oesophagus

Question 1

What is achalasia?

Answer 1

Aperistalsis in the body of the oesophagus and failure of relaxation of the LOS on initiation of swallowing
Long history of dysphagia (liquids and solids)
Regurgitation (aspiration pneumonia)
Severe retrosternal pain

Question 2

What is an upper oesophageal web?

Answer 2

Constriction near the UOS
Asymptomatic or produce dysphagia
Plummer-Vinson- iron deficiency anaemia, glossitis and angular stomatitis, women

Question 3

What is an oesophageal diverticulum?

Answer 3

Pouch lined with epithelium that can produce dysphagia and regurgitation
Pharyngeal pouch

Question 4

What is a schatzki ring?

Answer 4

Narrowing of the lower end of the oesophagus due to a ridge of mucosa or a fibrous membrane
Can occasionally produce dysphagia

Question 5

Where do cancers of the oesophagus occur?

Answer 5

40% in the middle third (SCC)
45% in the lower third at the cardia (adenocarcinomas)
Upper third is rare

Question 6

What are the risk factors for SCC of the oesophagus?

Answer 6

Smoking 
Heavy alcohol intake
Plummer-Vinson syndrome 
Achalasia 
Coeliac disease
Tylosis 
Diet deficient in vitamins

Question 7

What are the risk factors for adenocarcinomas of the oesophagus?

Answer 7

Long standing GORD
Barrett’s oesophagus
Smoking

Question 8

What is oesophageal candidiasis?

Answer 8

Characterised by white spots in the oropharynx with extension into the oesophagus. Associated with broad spectrum antibiotic usage, immunosupression and immunological disorders.
Malaise, sore throat, odynophagia and dysphagia