Pathology of the Oesophagus Flashcards
Acute oesophagitis
- after chemical ingestion
- in immunocompromised patients e.g HIV, AIDS, CMV, herpes
Causes of Chronic oesophagitis (GORD)
- resting tone of LOS is absent
- LOS tone does not increase when lying flat (patient often wakes at night)
- abnormal oesophageal motility
- delayed gastric emptying
- hiatus hernia
Investigations for GORD
- gastroscopy
- barium meal
Treatment for GORD
- PPIs
- H2 receptor antagonist
- metoclopramide (increased rate of gastric emptying)
- fundoplication (increased tone of LOS)
complications of GORD
- ulceration
- stricture formation
- Barrett’s
What is Barrett’s?
premalignant metaplastic change of squamous -> columnar, due to persistent reflux of acid
Treatment of Barrett’s
PPIs, surveilience, oesophagectomy
Why does Barrett’s put the patient at risk of malignancies?
as the metaplastic change may be followed by a dysplastic change
What is allergic oesophagitis?
allergic condition of the oesophagus, involving increased amounts of eosinphils and inflam
Aetiology of allergic oesophagitis
- males
- young
- personal of family history of allergies (in particular asthma)
Treatment of allergic oesophagitis
steroids, montelukast, chromoglycate
What are the three congenital conditions of the oesophagus?
- stenosis (narrowing)
- agenisis (absence of oesophagus)
- atresia and tracheo-oesophageal fistula
what is achalasia?
loss of peristalsis of the lower oesophagus and spasms of LOS
What does achalasia look like on imaging
dilatation and beak deformity
treatment of achalasia
- endoscopic balloon dilatation
- surgery to weaken the sphincter (must have a fundoplication performed also)
