Pathological Conditions: Esophagus

Question 1

Hiatal Hernia: Symptoms/Signs, Diagnostics & Treatment
https://www.youtube.com/watch?v=8Eer0eimDxE

Answer 1

Hiatal Hernia occurs when the esophageal hiatus is weak, which allows the abdominal esophagus and superior portion of the stomach to protrude into the thoracic cavity

Symptoms/Signs (S/SX):
. Acid reflux
. Mucosal erosion, ulceration, scarring
. Stricture (an abnormal narrowing of a bodily passage “as from inflammation, cancer, or the formation of scar tissue”)
. Burning, non-radiating pains
. Pain is positional

Diagnostics (DX):
. History
. Fluoroscopy during barium swallow (is diagnostic radiology exam using an X-ray to examine the upper gastrointestinal (GI) tract, specifically the esophagus, throat and back of the mouth. A barium swallow can help diagnose structural or functional issues of the upper GI tract.)
. Diagnostic endoscopy (Diagnostic procedure)
. Manometry (test senses the pressure and constriction of muscles in the esophagus as you swallow)

Medical Treatment:
. Medications to reduce acid production/ reflux
. Diet & sleeping position modifications

Surgical:
. Correction of anatomical defect (what sx is this?)
. Reconstruction of valve mechanism in lower esophagus (what sx is this?)
. Therapeutic endoscopy (what sx is this?)

Laparoscopic Nissen Fundoplication - Surgical procedure to correct hiatal hernia

Question 2

Motility disorders: Symptoms/Signs, Diagnostics & Treatment
https://www.youtube.com/watch?v=rc-ZnGg4QMA

Answer 2

Symptoms/Signs:
. Dysphagia (a medical term for difficulty swallowing)
. Regurgitation of undigested food

Diagnostics:
. X-ray w/ contrast medium
. Cineradiography (the process of making radiographs of moving objects (as the heart or joints) in sufficiently rapid sequence so that the radiographs or copies made from them may be projected as motion pictures compare cinefluorography. cineradiographic.)

Medical:
. Usually unhelpful but newer medications have been effective

Surgical:
. Endoscopic dilation can sometimes provide relief of symptoms: correct esophageal stri

Question 3

Achalasia (Motility Disorder): Symptoms/Signs, Diagnostics & Treatments
https://www.youtube.com/watch?v=coHQ3UPqvkw

Answer 3

a swallowing condition that affects the tube connecting the mouth and the stomach, called the esophagus. Damaged nerves make it hard for the muscles of the esophagus to squeeze food and liquid into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth

Symptoms/Signs:
. Weight loss
. Pain is uncommon
. Aspiration pneumonia

Diagnostics:
. Manometry

Surgical:
. Therapeutic endoscopic procedure
. Transection of the muscle

Question 4

Diverticula (Zenker’s): Symptoms/Signs, Diagnostics & Treatments
https://www.youtube.com/watch?v=VU1WT3E5k1g

Answer 4

is an outpouching that occurs at the junction of the lower part of the throat and the upper portion of the esophagus. The pouch forms because the muscle that divides the throat from the esophagus, the cricopharyngeal (CP) muscle, fails to relax during swallowing.

Symptoms/Signs:
. Regurgitation of recently swallowed material
. Choking
. Foul breath odor

Diagnostics:
. X-ray w/ contrast medium

Surgical:
. Excision of diverticula ( the wall of the large intestine, also called the colon, is smooth. An irregular, bulging pouch in the colon wall is called a diverticulum. Multiple pouches are called diverticula)
. Correction of cause

Question 5

Neoplasm (benign tumors are rare): Symptoms/Signs, Diagnostics & Treatment

Answer 5

Symptoms/Signs:
. Asymptomatic early
. Dysphagia (difficulty swallowing)
. Weight Loss
. Pain

Diagnostics:
. Barium contrast studies (An x-ray examination that evaluates only the pharynx and esophagus is called a barium swallow. In addition to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further improve the images. This procedure is called an air-contrast or double-contrast upper GI.)
. CT Scan

May be limited to palliation
. Radiotherapy
. Tracheostomy
. Extirpation (the act of removing or destroying something completely) of the esophagus
. Reconstruction

Question 6

Trauma: Symptoms/Signs, Diagnostics & Treatment

Answer 6

Symptoms/Signs:
. Perforation (usually the result of instrumentation)
. Ingestion of caustic (capable of destroying or eating away by chemical action) substances

Diagnostics:
. Varies with type

Surgical:
. Immediate intervention

Question 7

Gastroesophageal Reflux Disease (GERD) an example is a hernia
https://www.youtube.com/watch?v=DZuvYkxWLq8

Answer 7

Reflux esophagitis occurs in patients with GERD when toxic substances such as gastric acid, pepsin, and bile salts come into contact with the esophageal mucosa, resulting in damage to the distal esophageal mucosa and mucosal breaks that can be detected through endoscopy in 30% to 40% of patients