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Abdominal Radiology > Pharynx and Esophagus > Flashcards

Pharynx and Esophagus Flashcards

1
Q

studies dedicated to evaluation of swallowing disorders and suspected lesions of the pharynx and esophagus

A

Barium pharyngography, barium swallow, barium esophagography

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2
Q

Upper GI series, also called barium meal is an extended barium examination of the alimentary tract from the pharynx and esophagus down to the level of

A

ligament of Treitz

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3
Q

what should be done to distend and collapse the pharynx and optimize visualization of mucosal detail in Barium pharyngography

A

lateral and AP views of the pharynx are recorded with the patient phonating “eee” and “aaahh”

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4
Q

positioning of patient in esophagogram

A

upright position and in prone right anterior oblique positioning

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5
Q

pharynx extend from ____ to ____

A

nasal cavity to larynx

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6
Q

3 pharyngeal compartments

A

oropharynx, nasopharynx, hypopharynx

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7
Q

nasopharynx extends from ___ to ____

A

skull base to the soft palate

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8
Q

function of the nasopharynx

A

entirely respiratory

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9
Q

oropharynx extend from ___ to ____

A

posterior to the oral cavity and extends from the soft palate to hyoid bone

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10
Q

hypopharynx extend from ___ to ____

A

extends from hyoid bone to cricopharyngeus muscle

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11
Q

forms the anterior boundary of the oropharynx

A

base of the tongue

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12
Q

separates the larynx from the oropharynx and hypopharynx

A

epiglottis and aryepiglottic folds

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13
Q

two symmetrical pouches formed in the recess between the base of the tongue and epiglottis

A

valleculae

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14
Q

valleculae is divided by the ___ medially and bounded by ____ laterally

A

median glossoepiglottic fold and lateral glossoepiglottic fold

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15
Q

deep, symmetrical, lateral recesses formed by the protrusion of the larynx into the hypopharynx

A

piriform sinuses

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16
Q

extent of the esophagus

A

from the cricopharyngeus muscle at the level of C5-6 to the GEJ

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17
Q

muscle layers of the esophagus

A

outer longitudinal muscle layer and inner circular muscle layer lined by stratified squamous epithelium

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18
Q

esophagus lacks ____, which allows for rapid spread of tumor into adjacent tissues

A

serosal layer

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19
Q

segment of esophagus that is predominantly striated muscle

A

proximal 1/3

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20
Q

segment of esophagus that is predominantly smooth muscle

A

distal 2/3, below the level of the aortic arch

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21
Q

normal instrinsic impression on the esophagus are made by the

A

aortic arch, left main bronchus, left atrium

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22
Q

multiple regular, transverse folds, 1 mm thick, result from contraction of the longitudinal fibers in the muscularis mucosa. this pattern is called

A

feline esophagus

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23
Q

feline esophagus in humans is an early sign

A

dysmotility or esophagitis

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24
Q

Abnormal distention of the esophagus measures

A

more than 10 mm in the upper esophagus and more than 20 mm in lower esophagus

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25
Q

air fluid levels in the esophagus are normal or abnormal?

A

always abnormal

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26
Q

normal thickness of the wall of esophagus in CT and MR

A

2 to 4 mm

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27
Q

anatomy of the esophagogastric region is complex. The length of the esophagus is ___ and its termination is ___

A

length is tubular, termination is saccular

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28
Q

the saccular termination of the esophagus is called the

A

esophageal vestibule

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29
Q

the tubulovestibular junction of the esophagus is formed by a symmetrical muscular ring called

A

A ring

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30
Q

asymmetrical mucosal ring or notch that occurs at the junction of esophageal squamous epithelium with gastric columnar

A

B ring

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31
Q

B ring is also marked by this line which is a thin ragged line of demarcation seen on double-contrast views of lower esophagus

A

Z line

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32
Q

Radiographic markers of GEJ

A

B ring and Z line

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33
Q

It is a 2-4 cm long high pressure zone located in the esophageal vestibule. It is a physiologic rather than an anatomic structure

A

lower esophageal sphincter

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34
Q

angled opening in the diaphragm, formed by the edges of the diaphragmatic crura. On CT and MR, the crura appear as often prominent, teardrop-shaped structures of muscle density

A

esophageal hiatus

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35
Q

With normal breathing, the proximal vestibule and A ring lie in the

A

thorax

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36
Q

with normal breathing, the mid-vestibule is in the ____, the distal vestibule and B ring are in the _____

A

the mid-vestibule is in the esophageal hiatus, the distal vestibule and B ring are in the abdomen

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37
Q

with swallowing, the vestibule and B ring are seen in

A

vestibule opens and moves upward and the B ring may be seen 1 cm above the diaphragm

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38
Q

normal process of swallowing can be divided into

A

oral, pharyngeal and esophageal ohases

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39
Q

stage of swallowing that involves mastication, formation of bolus, and voluntary transport of the bolus from the oral cavity into the pharynx

A

oral stage

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40
Q

movement of larynx, laryngeal vestibule, epiglottis and aryepiglottic folds during swallowing

A

larynx elevates, laryngeal vestibule closes, epiglottis and aryepiglottic folds close over the opening into the larynx and deflect the bolus thru the lateral piriform recesses

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41
Q

functional upper esophageal sphincter is formed by

A

cricopharyngeus and other pharyngeal muscles

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42
Q

composed of a rapid wave of inhibition that opens the sphincters, followed by a slow wave of contraction that moves the bolus

A

primary peristalsis

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43
Q

appears as a stripping wave that traverses the entire esophagus from top to bottom

A

primary peristalsis

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44
Q

secondary peristalsis is initiated by the

A

distention of esophageal lumen

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45
Q

peristaltic wave that starts in the mid-esophagus and spreads simultaneously up and down the esophagus to clear reflux or any part of a bolus left behind

A

secondary peristalsis

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46
Q

nonproductive contractions associated with motility disorders. Irregular contractions follow one another at close intervals from the top to bottom of the esophagus

A

tertiary waves

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47
Q

contractions that cause a corkscrew or beaded appearance of the esophageal barium column

A

tertiary waves

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48
Q

defined as awareness of swallowing difficulty during the passage of solids or liquids from mouth to stomach

A

dysphagia

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49
Q

food “sticking in the throat” and painful swallowing is called

A

odynophagia

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50
Q

defined as entry of barium into the laryngeal vestibule without passage below the vocal cords

A

laryngeal penetration

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51
Q

aspiration is evident when the ingested bolus passes thru

A

vocal cords into the proximal trachea

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52
Q

this is attributable to failure of complete relaxation of the UES, commonly resulting in dysphagia and aspiration

A

cricopharyngeal achalasia

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53
Q

shelf-like impression on barium column at the pharyngoesophageal junction at the level of C5-6

A

cricopharyngeal bar

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54
Q

cricopharyngeus muscle is normally ____ between swallows and ____ during swallowing

A

normally closed between swallows, relaxes for passage of bolus during swallowing

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55
Q

when this is present during swallowing, it indicates dysfunction and incomplete opening

A

cricopharyngeal bar

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56
Q

narrowing of the esophageal lumen greater than how many percent is generally accepted as definite cause of dysphagia

A

50%

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57
Q

cricopharyngeal dysfunction is commonly associated with what conditions

A

GERD, Zenker diverticulum, neuromuscular disorders of the pharynx

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58
Q

disease of unknown etiology characterized by absence of peristalsis in the body of esophagus, marked increase in the resting pressure of LES, failure of LES to relax with swallowing

A

Achalasia

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59
Q

deficiency of ganglion cells in the myenteric plexus (Auerbach plexus) throughout the esophagus

A

achalasia

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60
Q

clinical presentation of this condition is insidious, usually at age 30 to 50 years, with dysphagia, regurgitation, foul breath and aspiration

A

achalasia

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61
Q

tertiary waves in achalasia are common in what stage of disease

A

early stage

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62
Q

tx of achalasia

A

balloon dilation or Heller myotomy

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63
Q

diseases that may mimic esophageal achalasia include

A

chagas disease, carcinoma of GEJ, peptic strictures

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64
Q

caused by destruction of ganglion cells of the esophagus due to a neurotoxin released by protozoa, Trypanosoma cruzi, endemic to South america, especially eastern Brazil. radiographic appearance is identical to achalasia. associated abnormalities include cardiomyopathy, megaduodenum, megaureter and megacolon

A

Chagas disease

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65
Q

this condition may mimic achalasia, but tends to involve a longer (> 3.5 cm) segment of the distal esophagus, is rigid, and tends to show more irregular tapering of the distal esophagus and mass effect

A

Carcinoma of GEJ

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66
Q

syndrome of unknown cause, characterized by multiple tertiary esophageal contractions, thickened esophageal wall, and intermittent dysphagia and chest . primary peristalsis is usually present, but the contractions are infrequent

A

Diffuse esophageal spasm

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67
Q

in this condition, LES is frequently dysfunctional and the condition commonly improves with injection of Clostridium botulinum toxin at the GEJ or with endoscopic balloon dilation of the LES

A

diffuse esophageal spasm

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68
Q

characterized on barium studies by intermittently absent of weakened primary esophageal peristalsis with simultaneous, nonperistaltic contractions that compartmentalize the esophagus, producing a classic corkscrew appearance. CT reveals circumferential thickening (5 to 15 mm) of the wall of the distal 5 cm of esophagus in 20% of patients

A

diffuse esophageal spasm

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69
Q

common cause of abnormalities of the oral, pharyngeal or esophageal phases of swallowing

A

neuromuscular dysfunction

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70
Q

most common cause of neurologic dysfunction causing swallowing problem include

A

cerebrovascular disease and stroke

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71
Q

systemic disorder of unknown case characterized by progressive atrophy of smooth muscle and progressive fibrosis of affected tissues. the esophagus is affected 75 to 80% of patients. presents with weak to absent peristalsis in the distal 2/3 of esophagus, delayed esophageal emptying, stiff dilated esophagus that does not collapse with emptying, wide-gaping LES with free gastroesophageal reflex

A

scleroderma

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72
Q

esophagitis frequently results in

A

abnormal esophageal motility and visualization of tertiary esophageal contractions

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73
Q

occurs as a result of incompetence of the LES. the resting pressure of LES is abnormally decreased and fails to increase with raised intra-abdominal pressure

A

GERD

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74
Q

complications of GERD

A

reflux esophagitis, stricture, development of Barrett esophagus and esophageal dysmotility

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75
Q

a finding of importance in treating GERD surgically

A

shortening of esophagus

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76
Q

provocative maneuvers to demonstrate GERD

A

Valsalva, leg raising and cough

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77
Q

most sensitive means of diagnosing GERD

A

monitoring of esophageal pH for 24 hours in an ambulatory patient

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78
Q

management of GERD

A

medically with agents that inhibit gastric acid production or surgically with fundoplication

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79
Q

normal esophageal hiatus should not exceed ___ mm

A

15 mm

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80
Q

protrusion of any portion of the stomach into the thorax. considered synonymous with GERD, however most patients with this condition do not have GERD or evidence of esophagitis. It delays the clearance of reflux and promotes development of RE

A

hiatus hernia

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81
Q

Most common hiatus hernia

A

sliding hiatal hernia

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82
Q

presence of retrocardiac mass with air-fluid level suggests

A

sliding hiatal hernia

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83
Q

crucial factors in producing symptoms of and causing complications in sliding hiatal hernia

A

function of LES and presence of pathologic GERD

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84
Q

most common type of paraesophageal hernia

A

mixed or compound hiatal hernia

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85
Q

type of hiatal hernia in which the GEJ remains in normal location, while a portion of the stomach herniates above the diaphragm

A

paraesophageal hernia

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86
Q

type of paraesophageal hernia wherein the GEJ is displaced into the thorax with a large portion of the stomach, which is usually abnormally rotated

A

Mixed or compound type

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87
Q

paraesophageal hernias, especially when large, with most of the stomach in the thorax, are at risk for

A

volvulus, obstruction, and ischemia

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88
Q

protrusions of pharyngeal mucosa through areas of weakness of the lateral pharyngeal wall

A

lateral pharyngeal diverticula

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89
Q

most common region of lateral pharyngeal diverticula

A

region of tonsillar fossa, thyrohyoid membrane

90
Q

mostly seen in wind instrument players; reflect increased intrapharyngeal pressusre

A

lateral pharyngeal diverticula

91
Q

complication of lateral pharyngeal diverticula

A

laryngeal penetration and aspiration

92
Q

Zenker diverticulum arises from

A

hypopharynx, just proximal to UES

93
Q

location of Zenker diverticulum

A

posterior midline at the cleavage plane known as Kilian dehiscence

94
Q

structure between the circular and oblique fibers of the cricopharyngeus muscle

A

Kilian dehiscence

95
Q

this diverticulum has a small neck, that is higher than the sac

A

Zenker diverticulum

96
Q

Zenker diverticulum is rarely found in what age

A

under age 40

97
Q

diverticulum that originate on the lateral wall of proximal cervical esophagus in a gap just below the cricopharyngeus and lateral to the longitudinal tendon of the esophagus

A

Kilian-Jamieson diverticula

98
Q

these diverticulum are less common and considerably smaller than Zenker diverticulum and appear on pharyngoesophagography as persistent left-sided or, less frequently, bilateral outpouchings from the proximal cervical esophagus below the cricopharyngeus

A

Kilian-Jamieson diverticula

99
Q

mid esophageal diverticula types

A

pulsion and traction

100
Q

diverticula occur as a result of distorted esophageal peristalsis

A

pulsion

101
Q

diverticula that occur because of fibrous inflammatory reactions of adjacent lymph nodes and contail all esophageal layers

A

traction diverticula

102
Q

most of these diverticulas have large mouths, empty well and are usually asymptomatic

A

mid esophageal diverticula

103
Q

diverticula that occur just above the LES, usually on the right side. usually found in patients with esophageal motility disorder. it has small neck, higher than sac, in which they may trap food and liquids and cause symptoms

A

epiphrenic diverticula

104
Q

small outpouchings of esophagus that usually occurs as a sequela of severe esophagitis

A

sacculation

105
Q

how to differentiate sacculations from ulcerations

A

smooth contour of sacculations

106
Q

dilated excretory ducts of deep mucus glands of esophagus. they appear as flask-shaped barium collections that extend from the lumen or as lines and flecks of barium outside the esophageal wall. tends to occur in clusters and in association with strictures

A

intramural pseudodiverticula

107
Q

intramural tracking that bridges is seen in

A

intramural pseudodiverticula

108
Q

radiographic signs of esophagitis

A

thickened esophageal folds (>3mm), limited esophageal distensibility (asymmetric flattening), abnormal motility, mucosal plaques and nodules, erosions and ulcerations, localized strictures and intramural pseudodiverticulosis (barium filling of dilated 1 to 3 mm submucosal glands)

109
Q

hallmark finding of esophagitis

A

ulcers

110
Q

small esophageal ulcers are found in

A

RE, herpes, acute radiation, drug-induced esophagitis, benign mucus membrane pemphigoid

111
Q

larger esophageal ulcers are found in

A

CMV, HIV, Barrett esophagus and carcinoma

112
Q

small esophageal ulcers measures

A

<1 cm

113
Q

large esophageal ulcers measure

A

> 1cm

114
Q

result of esophageal mucosal injury by exposure to gastroduodenal secretions

A

reflux esophagitis

115
Q

findings of RE are always prominent in the

A

distal esophagus and GEJ

116
Q

early change of RE

A

mucosal edema; granular or nodular pattern of esophagus

117
Q

most common cause of esophageal ulcerations

A

RE

118
Q

key in differentiating RE ulcers from those of herpes or drug induced esophagitis

A

prominence of the ulcerations in the distal rather than proximal or mid-esophagus

119
Q

complications of RE include

A

ulceration, bleeding, stricture, Barrett esophagus

120
Q

acquired condition of progressive columnar metaplasia of the distal esophagus caused by chronic gastroesophageal reflux. columnar rather than squamous epithelium line the esophagus

A

Barrett esophagus

121
Q

it is a premalignant condition of the esophagus, with a 30 to 40 times increased risk of developing adenocarcinoma

A

Barrett esophagus

122
Q

characteristic radiographic appearance of Barrett esophagus

A

high (mid-esophageal) stricture or deep ulcer in a patient with GERD

123
Q

reticular mucosal pattern of esophageal mucosa, resembling areae gastricae of stomach is also suggestive of

A

Barrett esophagus

124
Q

infectious esophagitis is found most commonly in patients with

A

compromised immune system, those who use steroids for a long time, cytotoxic drugs and AIDS

125
Q

most common cause of infectious esophagitis

A

Candida albicans

126
Q

prominent symptom of infectious esophagitis

A

odynophagia

127
Q

most characteristic radiographic finding of infectious esophagitis

A

plaque-like lesions demonstrated by air-contrast esophagrams

128
Q

fulminant diseases of infectious esophagitis produces _____ with a pattern of tiny bubbles at the top of the barium column

A

foamy esophagus

129
Q

begins as discrete vesicles that rupture to form discrete mucosal ulcers. ulcers may be linear, punctate or ring-like and have a characteristic radiolucent halo

A

Herpes simplex esophagitis

130
Q

most characteristic of herpes

A

discrete ulcers on a background of normal mucosa involving the mid-esophagus

131
Q

cause of fulminant esophagitis in patient with AIDS

A

CMV

132
Q

esophagitis that characteristically manifests as one or more large, flat, mucosal ulcers

A

CMV

133
Q

HIV esophagitis causes

A

giant ulcers and severe odynophagia

134
Q

least common portion of the GI tract to be involved by TB

A

esophagus

135
Q

manifestation of esopgeal TB

A

ulceration, stricture, sinus tract, abscess formation

136
Q

result of intake of oral medications that produce a focal inflammation in areas of contact with mucosa

A

Drug-induced esophagitis

137
Q

drugs that cause drug-induced esophagitis

A

tetracyline, doxycycline, quinine, aspirin, indomethacin, ascorbic acid, potassium chloride, theophylline

138
Q

radiographic appearance of drug-induced esophagitis

A

identical to herpes esophagitis, with discrete ulcers separated by normal mucosa in mid-esophagus

139
Q

healing in drug-induced esophagitis happens within ____ days of discontinuing the offending medication

A

7 to 10 days

140
Q

drug induced esophagitis appearance

A

feline esophagus

141
Q

agents that produce deep (full thickness) coagulation necrosis

A

alkaline agents/ liquid lye

142
Q

radiation esophagitis produces

A

long smooth stricture

143
Q

chemotherapeutic drug that greatly accentuate esophageal inflammation

A

doxorubicin hydrochloride (adriamycin)

144
Q

defined as any persistent narrowing of the esophagus

A

strictures

145
Q

most common cause of esophageal strictures

A

fibrosis induced by inflammation and neoplasm

146
Q

True or false: radiographic findings are not reliable in differentiating benign from malignant strictures

A

true

147
Q

causes of distal esophageal strictures

A

Barrett esophagus, mediastinal radiation, caustic ingestion and skin diseases such as pemphigoid, erythema multiforme, epidermolysis bullosa dystrophica

148
Q

benign esophageal strictures usually present as

A

smoothly tapering concentric narrowing

149
Q

malignant esophageal strictures are characteristically

A

abrupt, asymmetric, eccentric narrowings with irregular, nodular mucosa, tapered margins

150
Q

why does malignant esophageal strictures have tapered margins

A

because of ease of submucosal spread of tumor

151
Q

most common cause of esophageal stricture

A

RE

152
Q

small smooth sacculations and fixed transverse folds that cause scarring of

A

RE

153
Q

most RE stricture size are

A

1- 3 cm

154
Q

pathologic fixed ring-like stricture at the level of B ring , caused by RE

A

Schatzki ring

155
Q

typical Schatzki ring are of what size

A

2 to 4 mm in length

156
Q

long term nasogastric intubation may cause

A

long segment stricture

157
Q

Barrett esophagus tend to be high in the mid esophagus and may be smooth and tapered or ring-like narrowings. the high position is because of

A

tendency for strictures to occur at the squamocolumnar junction, which has been displaced to a position well above GEJ

158
Q

corrosive strictures appears

A

long and symmetrical

159
Q

this type of esophagitis may occur in patients who have undergone partial or total gastrectomy

A

alkaline reflux esophagitis

160
Q

reflux of bile or pancreatic secretions into the esophagus results in

A

development of severe alkaline reflux esophagitis and distal esophageal strictures

161
Q

this surgical procedure helps prevent reflux of bile and pancreatic secretion into the esophagus

A

Roux-en-Y reconstruction

162
Q

this should be suspected when barium examination performed in patients who have undergone partial or total gastrectomy or gastrojejunostomy reveals a long stricture in the distal esophagus

A

Alkaline reflux stricture

163
Q

increasingly common diagnosis made most often in young men with a history of allergies

A

eosinophilic esophagitis

164
Q

presents with long-standing history of dysphagia and food impaction. Barium studies demonstrate smooth, long-segment narrowing of the esophagus or a series of ring-like strictures called “ringed esophagus”

A

eosinophilic esophagitis

165
Q

treatment of eosinophilic esophagitis

A

steroids

166
Q

doses of ___ Gy to esophagus causes radiation strictures

A

50 to 60 Gy

167
Q

strictures from radiation therapy happens after how many months

A

3-6 months after radiotherapy

168
Q

radiation induced esophageal strictures appears

A

smooth and tapered and usually in the upper or mid-esophagus

169
Q

characteristic esophagram finding of malignant stricture

A

prominent or nodular shoulders

170
Q

they are thin (1-2 mm) delicate membranes that sweep partially accross the esophageal lumen

A

Webs

171
Q

pharyngeal webs most commonly arise from the

A

anterior wall of hypopharynx

172
Q

esophageal webs may occur anywhere, but they are most common in the

A

cervical esophagus just distal to the cricopharyngeus impression

173
Q

causes of extrinsic compression in the esophagus

A

lung carcinoma, lymphoma, metastasis to mediastinal nodes, tuberculosis, histoplasmosis

174
Q

thick esophageal folds are commonly present in

A

RE

175
Q

appear as serpiginous filling defects that change in size with changes in intrathoracic pressure and that collapse with esophageal peristalsis and distention

A

varices

176
Q

esophageal varices are best demonstrated with what imaging

A

UGI with mucosal relief views

177
Q

refers to portosystemic collateral veins that enlarge because of portal hypertension

A

uphill varices

178
Q

uphill varices are formed by

A

coronary vein collaterals connect with gastroesophageal varices that drain into the IVC via azygos system

179
Q

formed as a result of obstruction of SVC with drainage from the azygos system through esophageal varices to portal vein

A

downhill varices

180
Q

these are thick, tortuous, longitudinal folds that resemble varices but are rigid and persistent

A

varicoid carcinoma

181
Q

appears as intraluminal mass in the pharynx seen as filling defect, abnormal luminal contour, or focal increased density, mucosal irregularity owing to ulceration or mucosal elevations and asymmetrical distensibility due to infiltrating tumor or extrinsic nodal mass

A

pharyngeal carcinoma

182
Q

most pharyngeal carcinoma are

A

Squamous cell CA

183
Q

pharyngeal carcinomas usually arise from

A

base of tongue, palatine tonsil, posterior pharyngeal wall, piriform sinus

184
Q

benign lesions that typically involve the valleculae and should not be mistake for pharyngeal neoplasm. appear as smooth, well-defined round or oval filling defects best appreciated on frontal views. they arise from dilation of mucus glands caused by chronic inflammation

A

pharyngeal retention cysts

185
Q

true or false: pharyngeal retention cysts are never malignant

A

true

186
Q

lymphoma of pharynx usually manifest as

A

large, bulky tumor of lingual or palatine tonsils

187
Q

most common cell type of esophageal carcinoma related to increasing incidence of GERD

A

adenocarcinoma

188
Q

arises from malignant transformation of columnar epithelium of Barrett esophagus in the lower third of esophagus

A

esophageal adenocarcinoma

189
Q

arises from stratified squamous epithelium that lines the entire esophagus

A

squamous cell carcinoma

190
Q

imaging features of two cell types of esophageal carcinoma are indistinguishable, except that adenocarcinoma is almost always

A

distal, usually invades the GEJ and is much more likely to invade the stomach

191
Q

esophageal tumors assume four basic imaging patterns, namely

A

annular constricting lesion, polypoid pattern, infiltrative, ulcerated mass

192
Q

this pattern of esophageal tumor appears as an irregular ulcerated stricture, which is most common

A

annular constricting lesion

193
Q

pattern of esophageal tumor that causes an intraluminal filling defect

A

polypoid pattern

194
Q

pattern of esophageal tumor that grows predominantly in the submucosa and may simulate a benign stricture

A

infiltrative pattern

195
Q

least common pattern of esophageal tumor

A

ulcerative

196
Q

esophageal tumors spreads quickly due to

A

direct invasion into adjacent tissues because of lack of serosal covering on esophagus

197
Q

lymphatic spread of esophageal tumor

A

neck, mediastinum, below diaphragm

198
Q

hematogeneous spread of esophageal tumor

A

lung, liver and adrenal gland

199
Q

esophageal malignancy findings

A

irregular thickening of the esophageal wall (> 5mm), eccentric narowing of lumen, dilation of esophagus above the area of narrowing, invasion of periesophageal tissues and metastases to mediastinal lymph nodes and liver

200
Q

diagnosis of esophageal malignancy are through

A

endoscopy and biopsy

201
Q

most common benign neoplasm of the esophagus, accounting for 50% if all benign esophageal neoplasms

A

leiomyoma

202
Q

true or false: GISTs are common in the rest of the GI tract and rare in the esophagus

A

true

203
Q

esophageal tumor that is firm, well encapsulated, and arises in the wall

A

leiomyoma

204
Q

most commonly affected age group in esophageal leiomyoma

A

25 to 35 years old

205
Q

true or false: most cases of esophageal leiomyoma has no symptoms

A

true

206
Q

strongly indicative of leiomyoma

A

calcifications

207
Q

rare cause of esophageal filling defect that are benign, composed of fatty and fibrous tissue with accompanying blood vessels. appears as large elongated intraluminal masses in the upper esophagus

A

fibrovascular polyps

208
Q

congenital abnormalities in the esophagus that are usually incidental findings presenting without symptoms. 60% of which occurs in the lower esophagus. CT shows a well-defined cystic mass

A

esophageal duplication cysts

209
Q

differential diagnosis for esophageal duplication cysts include

A

bronchogenic and neuroenteric cyst

210
Q

extrinsic lesions to the esophagus that may simulate an esophageal mass or filling defect. causes include

A

mediastinal adenopathy, lung carcinoma, vascular structures

211
Q

arises from the aorta distal to the left subclavian artery. to reach its destination, it must cross the mediastinum behind the esophagus. it causes a characteristic upward-slanting linear filling defect on the posterior aspect of esophagus

A

aberrant right subclavian artery

212
Q

life-threatening event requiring prompt diagnosis and treatment in which more than half of the cases are related to esophageal instrumentation

A

esophageal perforation

213
Q

chest radiograph findings in esophageal perforation

A

widened mediastinum, pleural effusion, pneumohydrothorax

214
Q

contrast studies for esophageal perforation

A

contrast studies should be performed initially with low-osmolar water soluble agents and if negative, followed by repeating the study with barium

215
Q

key finding in esophageal perforation

A

focal or diffuse extravasation of contrast outside the esophagus

216
Q

blunt trauma may tear the esophagus by what mechanism

A

increase in intraesophageal pressure

217
Q

refers to rupture of the esophageal wall as a result of forceful vomiting

A

Boerhaave syndrome

218
Q

the tear in Boerhaave syndrome is usually in the

A

left posterior wall near the left crus of diaphragm

219
Q

tears that involves only the mucosa and not the full thickness of the esophagus. tears are usually caused by violent retching and copious hematemesis

A

Mallory-Weiss tear

220
Q

Mallory-Weiss tear appears ____

A

longitudinally oriented barium collection, 1 to 4 cm in length in the distal esophagus

221
Q

impacted foreign bodies in the esophagus may be removed by

A

use of Foley balloon catheter or wire basket or by gaseous distention with gas-producing crystals

Abdominal Radiology (14 decks)

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