RGO Flashcards

1
Q

Dg clinique du RGO

A

1/ pyrosis = brulures retrosternales ascendente, point depart epigastrique

2/ regurgitation ascides
3/ post prandial
Pas effort vomissement ni de toux
Sd postural= sg du lacet
Reveil nocturne= gravitée
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2
Q

Examen complementaires?

A

Rien si forme typique

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3
Q

Quand faire examen complementaires devant RGO

lequel?

A

EOGD
SI
1/ signes d’alarmes
Dysphagies, odynophagies, amaigrissement, anemie,EAG, fievre

2/AGE>50

3/ ttt inefficace

4/ symptomatologie atypique
Laryngite post, odynophagie, toux chronique

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4
Q

Resultat de EOGD

A

1/ oesophagite 1/3

  • 1 non conflient, non circonferentiel
  • 2 confluent
  • 3 circonferentiel
  • 4 ebo, ulcere

2/ si normal
Faire ttt epreuve
Ou ph metriesur 24h

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5
Q

Complications du rgo

A

1/ stenose peptique+++ ( 2/3sup 1/3 inf zone ebo)
2/ ulcere peptique(+ hemorragie, perforation)
3/EBO= prekc ou oesophage de barrett = metaplasie intestinal
3/ adenocarcinome sur EBO

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6
Q

Symptome extra dig du RGO

A
Penser RGO si bilan cardio, pulm, orl normal et Que
Toux
Dyspnee asthmatiforme
Enrouement
Dysesthesie buccu pharyngé
Otalgie
Laryngite postérieur
Douleur précordiales
Gingivites et ou carries dentaires
Tb sommeil av micro eveils nocturnes
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7
Q

Quand et comment ttt rgo

A
1/ RGO <1x/sem moderee
Mesure posturela tete 45°, perte poids, arret oh tb, 
Alginate
Anti histaminique
Voir ipp1/2 dose a la demande si echec
2/ RGO >1x/ sem
\+/- oesophagite stade 1 ou 2 
ipp x 4 sem1/2 doses
Si persustance pleines dosesx4 sem 
Ttt entretien dose minimum efficace

3/ OESOPHAGITE SEVERE 3-4
Recidive fq
Complications
IPP pleines dosesx8 sem+ contole FOGD

4/ chirurgie fundoplicature
Resistance ttt
Dependant IPP
hernie hiatal volumineuse
Regur'gitation reguliere

Ss coeliosscopie

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8
Q

Quand ttt EBO

A

Si dysplasie de haut grade: chirurgie
Si symptomes IPP doubles doses + eogd 2 mois controle
Dysplasie bas grade : controle FOGD/6m

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