Path 3 Esophagus Flashcards
Esophagus lining
Non-keratinized stratified squamous
Most common congenital anomaly
- Tracheoesophageal Fistulas
- Commonly with atresia
Scleroderma
- Autoimmune disease
- Systemically affects Esophagus, Kidneys, Heart, and Lungs
Zenker diverticulum
- Pharyngoesophageal diverticulum
- Immediately above upper esophageal sphincter
Traction diverticulum
Mid esophagus
Epiphrenic diverticulum
Right above diaphragm
Plummer-Vinson syndrome
- Iron deficiency anemia
- Esophageal web
- Atrophic glossitis (beefy red tongue)
Esophageal Webs
- Women >40
- Increased risk for SQC
Mallory-Weiss Tear
- Laceration at gastroesophageal junction
- Caused by wretched vomiting
- High risk of transmural rupture
Boerhaave syndrome
Esophageal rupture -> air in mediastinum, subcutaneous emphysema
Esophageal Varices
-Increased portal pressure
Odynophagia
Pain on swallowing
Nutcracker Esophagus
- Excessively strong contractions
- Associated with GERD (Tx same)
- Outer longitudinal contracts independently from inner circular
Diffuse Esophageal Spasms
-Diffuse uncoordinated peristalsis
Achalasia
- Absence of peristalsis and failure of LES relaxation
- Due to myenteric ganglion cell damage
Achalasia secondary causes
- Chagas disease (Trypanosoma cruzi)
- Infiltrative malignancy, amyloidosis, sarcoidosis, scleroderma
Achalasia xray appearance
Bird-beak sign on barium swallow
Chagas Disease
- T. cruzi
- Destruction of autonomic nervous system in GI and Heart
CMV v Herpes histology
Cytoplasmic v Nuclear inclusions
Most common esophagitis
Reflux esophagitis due to absent LES tone
GERD histology
Intraepithelial eosinophils and neutrophils
GERD Tx
PPI, H2-R antagonists
Barrett esophagus change
Squamous -> columnar, goblet
intestinal metaplasia
Adenocarcinoma
- Lower 1/3 of esophagus
- From GERD
- Caucasian men
Squamous Cell Carcinoma
- Upper or middle 1/3 of esophagus
- From alcohol, tobacco, Achalasia, Esophageal Web, chemical injury
- African American men
Esophageal cancer with hoarseness and cough
Squamous Cell Carcinoma