Surgical Cases

Question 1

A pt presents with solid and liquid dysphagia and subsequent regurgitation. Radiographic contrast studies shows “birds beak” sign or dilated esophageal body with inferior narrowing. Manometry studies shows loss of esophageal peristalsis. This is likely _____. The long term complications of this are _____. The sphincter involved in this problem is the _____.

Answer 1

Achalasia. Barrett’s esophagus and subsequent ESOPHAGEAL CARCINOMA. Lower esophageal sphincter (LES)

Question 2

A pt presents with dysphagia, a neck mass, ass breath, and food regurgitation. A _____ swallow shows a false diverticulum at the upper esophageal sphincter. This is called _____. What would you do about it?

Answer 2

Zenker’s diverticulum. Diverticulotomy.

Question 3

An ALCOHOLIC pt who was BINGE DRINKING presents to clinic with epigastric pain, thoracic substernal pain, and bloody emesis. Pt states she was VOMITING after bingeing and then began RETCHING VIOLENTLY and VOMITING bloody vomitus. This is likely _____. Presence of a _____ is another condition that commonly compounds this problem. How would you diagnose it?

Answer 3

Mallory-Weiss Syndrome. Hiatal hernia. EGD for diagnosis.