Barrett's Esophagus Flashcards Preview

Cameron's Esophagus and Spleen > Barrett's Esophagus > Flashcards

Flashcards in Barrett's Esophagus Deck (15):
1

Appearance of Barrett's endoscopically

Salmon colored appeance of mucosa

2

What percentage of patients with Barrett's esophagus with high grade dysplasia will progress to cancer?

10-30%

3

What are the recommended guidelines for biopsies in Barrett's esophagus?

Four quadrant biopsies at 2cm intervals from 1cm below EG junction to 1cm above the squamocolumnar junction.

4

What is the interval between endoscopic surveillance in Barrett's if no dysplastic changes are seen on biopsy?

2 to 3 years

5

What if low grade dysplasia is found on endoscopic evaluation of Barretts?

Recommend endoscopic surveillance at 6 month intervals for first year, then yearly if no progression

6

If a patient presents with Barrett's and high grade dysplasia on biopsy, what is recommended before a definitive diagnosis can be made?

Diagnosis of high grade dysplasia must be confirmed by a second, independent, experienced pathologist.

7

What is the prevalence of low grade dysplasia in Barrett's?

15-25%

8

What is the prevalence of high grade dysplasia in Barrett's?

5%

9

If a patient presents with high grade dysplasia, what are his treatment options?

Continued surveillance until carcinoma is identified, mucosal ablative techniques, and esophagectomy.

10

A patient with BE with high grade dysplasia undergoes an esophagectomy. What is the likelihood of finding invasive carcinoma in the specimen?

40%!!!!!

11

What is the recommended treatment for high grade Barrett's?

Esophagectomy

12

How can early adenocarcinoma within the Barrett's mucosa be removed?

With EMR (endoscopic mucosal resection)

13

How is Barrett's medically treated?

Lifetime proton pump inhibitors

14

What role does antireflux surgery have in Barrett's esophagus?

Minimizing reflux symptoms (evidence that controlling symptoms isimportant to protect against dysplastic changes and promote regression)

15

True or False: If a patient with a history of Barrett's esophagus (w/ no dysplasia) undergoes antireflux surgery, they require no further follow-up and the risk of cancer is eliminated.

False. They still require endoscopic surveillance because antireflux surgery has not been shown to clearly alter disease progression from metaplasia to carcinoma.