Patho- Esophageal Diseases Flashcards
Oesophagitis is ……..
Inflammation of the oesophagus
Causes of Oesophagitis
- GERD
- Corrosives ( acids , alkalis) and chemicals
• Infections
• Radiation
Oesopahageal varices is ……….
Dilated tortuous veins lying within the submucosa with distal oesophagus
Cause of Oesopahageal varices
portal hypertension
Complication of Oesopahageal varices
Rupture may occur fatal haematemesis
Achalasia is ……..
failure to relax,’’ of the lower esophageal sphincter response to swallowing .
Pathogenesis of Achalasia
loss of ganglion cells in the myeteric plexus
Types of Achalasia
- Primary achalasia: uncertain etiology
- Secondary achalasia: e.g
Chagas disease (Trypanosoma cruzi)
major abonomalities in achalasia:
(1) Aperistalsis
(2) partial or incomplete relaxation of the lower esophageal sphincter
(3) increased resting tone of the lower esophageal sphincter
Complication of Achalasia
- inflammation and ulceration
- dysphagia
- Nocturnal regurgitation
and aspration of undigested food - Esophageal squamous cell carcinoma (the most serious
Longitudinal tears at the esophagogastric junction is called …………
Lacerations (Mallory-Weiss Syndrome)
Causes of Lacerations
chronic alcoholics or sever vomiting
Lacerations affect which layer of esophagus?
mucsoa only.
[Gastric content reflux in distal oesophagus]
Reflux oesophagitis (GERD)
Gross of GERD
- Redding
- Ulceration
- Fibrous narrowing
Microscopic picture of GERD
1) Hyperplasia: of basal cells
2) Elongation: of lamina propria
3) Vasodilatation
4) Infiltration: of epithelium by PNLS & esinophils
5) Superficial necrosis & ulceration: severe cases
Complications of GERD
(1) PU
(2) Scarring stricture
(3) Barrett’s esophagus
Barrett›s oesophagus affect which part of esophagus? And what is that effect ?
metaplastic changes in %10 of lower oesophagus from Squamous >
Columnar «intestinal epithelium»
Describe diagnosis of Barrett›s oesophagus
endoscopy with biopsy >3 cm above gastro-esophageal junction
Complications of Barrett›s oesophagus
risk for adenocarcinoma.
Causes of Barrett›s oesophagus
1) Lumen : F.B
2)Wall :
1- Congenital: stenosis, web, atresia
2- Inflammatory: oesophagitis, PU.
3- Traumatic : due to corrosives ( acids , alkalies)
4- Tumors: carcinoma, leiomyoma.
5- Achalasia of cardia
6- Plummer-Vinson $
3) Pressure from outside :
•Enlarged mediastinal LNs
» Lymphoma
» Sarcoidosis
» T.B
•Bronchogenic carcinoma
•Aortic aneurysm
Predesposing factors of Carcinoma of oesophagus
- Male >50yrs
- Dietary:
-Consumption of very hot beverage
-Fungal contamination of food stuff.
- nitrites المواد الحافظة
- def. of vits. («A») and minerals as (Zn) - Oesophageal disorders:
- Achalasia & diverticula
- Plummer-Vinson > $ post cricoid carcinoma (Female)
- Chr. Oesophagitis, reflux with Barrett’s - Alcohol & smoking
- HPV infection
Gross of Carcinoma of oesophagus
1) Fungating polypoid Mass
2) ulcerating
3) Diffuse infiltrative
Microscopic picture of Carcinoma of oesophagus
o SCC %90
o Adenocarcinoma %10
Sites of Carcinoma of oesophagus
1st 1/3
2nd 1/3 (ssc)
3rd 1/3 ( adenoma)
Spread of Carcinoma of oesophagus
• Local:
oesophagus then trachea, bone, lung,mediastinum aorta fatal
• Lymphatic:
Cervical, mediastinal, abdominal LNs (early)
• Blood:
Liver ,Lung , Brain , Bone , Renal , Supra- renal ( late )
Most common benign tumor of esophagus
Leomyoma
