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GI Surgical Aspects of Esophagus-4
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33
Accounting
Kindergarten
10/10/2012

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