Surgical Aspects Esophageal Dx

Question 1

Esophageal Manometry

Answer 1

• Intramluminal pressure: Assess peristalsis + sphincters
• Dysphagia, GERD
• Noncardiac chest pain

Question 2

Esophageal Function Test + pH monitoring types

Answer 2

Traditional: Time the Entire esophagus is exposed toacid

Bravo/wireless: Placed under anesthesia; Measures time a fixed point is exposed

Question 3

Esophageal Function TestMultichannel Intramural Impedance (MII)

Answer 3

• Catheter that detects intraluminal bolus movement
• Dysphagia, heartburn, regurg, noncardiac chest pain, pre-op
• Non-acid GER

Question 4

Sliding HH Tx

Answer 4

Treat underlying GERD

Question 5

Paraesophageal HH Tx

Answer 5

If symptomatic, Surgery is indicated

Question 6

Nissen Fundoplication

Answer 6

• most effective Sx for GERD

Question 7

Distal Esophageal Spasm

Answer 7

• impaired inhibitory innervation
• Dysfunction of NO?
• Rosary bead appearance on esophagram

Question 8

Hypercontractile Esophagus

Answer 8

• Excessive excitation + smooth muscle hypertrophy

- Normal Peristalsis

Question 9

Systemic Scleroderma + Esophagus

Answer 9

• Absent peristalsis due to atrophy of the smooth muscle in the lower two-thirds
• Proximal esophagus spared

Question 10

How are State T1 esophageal cancers treated?

Answer 10

Esophagectomy

Question 11

Diagnostic tests Esophagus

Answer 11

• CXR
• CT w/ Contrast
• Gastrografin esophagram