Term
Esophageal motility is due to |
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Definition
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a condition in which part of the stomach pushes upward through the diaphragm. |
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Occurs when the gastro esophageal junction and part of the stomach slides upward into the chest. Most common hernia and affects persons with increased intra-abdominal pressure (pregnancy, abdominal tumor) |
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Asymptomatic presentation, however, overweight individuals complain of symptoms of reflux: localized, burning epigastric pain, substernal tightness, worse when lying down. Exacerbated by alcohol, aspirin, caffeine, tobacco |
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Chronic inflammation of the distal esophagus and exposure to acidic gastric juice leads to |
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Definition
mucosal erosion, scarring, stricture and obstruction |
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occurs when part of the stomach is squeezed up through the diaphragm beside the esophagus |
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Definition
Paraesophageal hiatal hernia |
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Term
hernia Symptoms include: incarceration (hernia is stuck) strangulation (ishcemia) dysphagia bleeding respiratory distress |
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Definition
Paraesophageal hiatal hernia |
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Term
Diagnosis of hiatal hernia is confirmed by |
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Definition
barium swallow showing the gastric mucous membrane above the diaphragm |
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Treatment for a hiatal hernia |
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Definition
avoid aggravating factors antacid increasing gastric pH wt loss elevating head in bed |
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Surgical correction of a sliding hiatal hernia involves |
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Definition
reconstructing the LES by wrapping a portion of the stomach around the lower esophagus to create a valve. |
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A new solution that does not require an abdominal incision for esophageal surgery. Advantage include shorter recovery time and reduced discomfort |
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Definition
Transoral Incisionless Fundoplication (TIF) |
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an esophageal motility disorder caused by failure of the esophageal sphincter to relax. Present with painless dysphagia, regurgitation, wt loss, aspiration pneumonia. |
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Results in progressive dilation of the proximal esophagus, presenting as a bird beak on radiograph |
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Definition
Surgical widening via endoscopy Esophageal Myotomy (muscle cutting) Meds don't work |
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Second most common esophageal motility disorder. |
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Are a result of high intraluminal pressure against a weakness in the esophageal wall. |
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Definition
Pulsion diverticula (ex. Zenker's) |
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result from pulling on the esophagus by an adjacent inflammatory process |
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related to a dysfuntion of the cricopharyngeal muscle. Patients complain of regurgitation of recently swallowed food, choking, breath odor. |
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Zenker's Diverticulum treatment |
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Definition
Excision of diverticula or myotomy |
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Term
Diverticula of the distal third of the esophagus are generally associated with dysfunction of |
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Occur in the middle third of the esophagus as a result of mediastinal inflammation or histoplasmosis (asymptomatic) |
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Usually arise from squamous epithelium and commonly affect black men with alcohol/tobacco abuse. Progressive dysphagia |
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Definition
Malignant esophagus neoplasms |
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Term
Patient may develop this due to a malignant neoplasm of the esophagus. Characterized by coughing after swallowing |
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If a patient has Barrett's esophagus and is unresponsive to treatment you need to do |
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Malignant tumors are visible on barium contrast studies as a rough encroachment on the esophageal luman called |
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Type of diagnostic study on the chest and uppper abdomen to assess the extent of tumor involvement in the esophagus |
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Treatment apprach should be focused on treating what for Malignant tumors |
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Upper esophageal tumors treated with |
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Middle esophageal tumors are most difficult to treat and involve |
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Definition
thoracic esophagectomy and bypass. New gastric tube |
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Distal esophageal tumors a best treated with |
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Definition
esophagogastric resection and end to end anastomosis |
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Term
spontaneous perforation secondary to forceful vomiting |
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Definition
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presents suddenly and include profound shock, mediastinal sepsis, severe chest or abdominal pain, hypotension, diaphoresis, and nausea and vomiting. Requires aggressive surgical intervention |
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For ingestion of caustic material, can be accidental or suicidal, What is not recommended |
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Definition
Neutralization, emesis, and steroids |
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