Oral and Oesophageal Pathology Flashcards
inflammatory disorders of oesophagus
acute oesophagitis
chronic oesophagitis
acute oesophagitis
rare
corrosive following chemical ingestion
infective in immunocompromised patients
chronic oesophagitis
common
reflux disease ‘refulx oesophagitis’
rare causes include crohns disease
reflux oesophagitis
inflammation of oesophagus due to refluxed low pH gastric content
may be due to defective sphincter mechanism +/- hiatus hernia
abnormal oesophageal motility
increased intra-abdominal pressure (pregnancy)
relax oesohagitis - microscopic
basal zone epithelial expansion
intraepithelial neutrophils, lymphocytes and eosinophils
reflux oesophagitis - complications
ulceration (bleeding), stricture
BARRETTS OESOPHAGUS
barretts oesophagus - metaplasia
due to persistent reflux of acid or bile
may be due to expansion of columnar epithelium from gastric glands or from submucosal glands
may be due to differentiation from oesophagus stem cells
protective response, faster regeneration
barretts oesophagus - macroscopic and microscopic
red velvety mucosa in lower oesophagus
columnar lined mucosa with intestinal metaplasia
barretts oesophagus
unstable mucous - continuing damage
increased risk of developing dyslexia and carcinoma of the oesophagus
requires surveillance although valve of this is disputed
allergic oesophagitis
eosinophilic oesphagitis
personal/family history of allergy
corrugated or ‘spotty’ oesophagus
treatment = steroids, chromoglycate, mongdlukast
oesophageal tumours
benign and malignant
oesophageal tumours - benign
squamous, papilloma
rare papillary, asymptomatic, HPV related
oesophageal tumours -malignant
squamous cell carcinoma, adenocarcinoma
squamous cell carcinoma
commoner in males
zinc deficiency, tannic acid, smoking, alcohol, HPV, oesophagitis, genetic
adenocarcinoma
commoner in Caucasians
commoner is males/obesity
