Upper GI pathology

Question 1

Barium swallow pathologies

Answer 1

dysphagia

• oesophageal strictures
• oesophageal cancer
• Achalasia

Dyspepsia

• reflux and oesophagitis
• oesophageal atresia

Question 2

Dysphagia

Answer 2

Difficulty/obstruction of swallowing

- evaluation of oesophagus allows you to see motility/reflux

Question 3

cervical spine osteophytes

Answer 3

• may cause compression of the oesophagus

- might lead to dysphagia and consequently weight loss

Question 4

oesophageal strictures

Answer 4

• benign strictures
• radiation induced - can damage soft mucosal structures
• malignancy- squamous cell carcinoma (SCC), andenocarcinoma

Question 5

oesophageal cancer

Answer 5

-apple core appearance
- very poor survival rate
- most common in those over 60
accounts for about 1% of malignancies

Question 6

Achalasia

Answer 6

• is a functional disorder of the cardiac sphincter, which fails to relax during swallowing
• dilated oesophagus with tapered stricture at its lower end

Question 7

reflux (dyspepsia)

Answer 7

can cause oesophagitis

• where mucosa pf the lower oesophagus becomes inflamed, due to reflux of gastric acid through incompetent cardiac sphincter
• this can cause scarring

Question 8

symptoms of oesophagitis

Answer 8

• chest pain
• vomiting
• haematemesis- vomiting blood

Question 9

hiatus hernia

Answer 9

• where part of the stomach moves up into the chest, through an opening in the diaphragm

Question 10

Barium meals common pathologies

Answer 10

• gastritis
• peptic ulcers/perforation
• bezoars
• volvulus of stomach
• ca of stomach

Question 11

cause of gastritis

Answer 11

• inflammation of the stomach

- can be acute or chronic

Question 12

acute causes of gastritis

Answer 12

• alcohol over consumption
• diet
• food poisoning
• infections such as flu

Question 13

chronic caused of gastritis

Answer 13

• stress

- long term medication

Question 14

gastric/peptic ulcer cause

Answer 14

• inflammatory process and in the stomach is caused by pepsin, which breaks through the mucosal membrane
• can lead perforation or sepsis in several stages

Question 15

bezoars

Answer 15

• gradual accumulation of fibrous material within the lumen
• surgery needed to remove the material
• phytobezoars- caused by plant material
• Trichobezoars - caused by chewing long hair

Question 16

stomach volvulus

Answer 16

• twisting of part or all of the stomach by more than 180 degrees

Question 17

stomach volvulus leads to

Answer 17

obstruction of the flow of material
variable loss of blood supply
possible tissue death

Question 18

crohn’s disease

Answer 18

• inflammatory bowel condition that can occur in the small or large bowel.

Question 19

age peaks of crohn’s disease

Answer 19

15-30 and 60-80

Question 20

crohn’s disease can cause

Answer 20

diarrhoea, abdominal pain, weight loss, fatigue

Question 21

sialography is done for

Answer 21

salivary duct obstruction
identifying ductal strictures
suspected duct dilation

Question 22

duct dilation

Answer 22

• infection or autoimmune condition e.g. spleen syndrome

Question 23

sialectasis

Answer 23

suspected duct dilation - infection

Question 24

ERCP