Pt with Asthma symptoms and GERD not responsive to antacids. Allergic, eosinophilic infiltration of the esophagus
Outpouching of posterior hypopharynx, men over 60, regurgitant symptoms several hours after eating, halitosis
Decreased peristalsis, increased sphincter tone, slowly progressive dysphagia, episodic regurgitation. Barium swallow: parrot-beak - dilated esophagus tapered to distal obstruction
Dysphagia to liquids and solids caused by injury at brainstem or cranial nerves
Corkscrew appearance on barium swallow
Diffuse Esophageal Spasm
Caused by forceful vomiting. Associated with alcohol use, upper endoscopy showing superficial longitudinal mucosal erosions
Mallory Weiss tear
Progressive dysphagia to solid foods along with weight loss, reflux and hematemesis
Complication of Barrett’s esophagus (screen barrett’s patients every 3-5 years with endoscopy), affects distal (lower) 1/3rd of esophagus
Adenocarcinoma of the esophagus
Associated with smoking and alcohol use, affects proximal (upper) 2/3rds of esophagus, progressive dysphagia, weight loss, hoarseness
Squamous cell carcinoma of the esophagus
Esophageal webs + dysphagia + iron deficiency anemia
Solid food dysphagia in a patient with a history of GERD
Often asymptomatic until hematemesis often a complication of portal hypertension (from cirrhosis)
What level of eosinophilia is diagnostic of eosinophilic esophagitis on biopsy?
> 15 eosinophils/HPF
In addition to peptic stricture what is another complication of chronic GERD?
What is the Dx? Hematemesis from esophageal laceration after forceful retching.
Motility disorder caused by degeneration of Auerbach’s plexus?
What medication may be used to treat stable esophageal varices?
Name 2 viruses seen in infectious esophagitis.
HSV (Herpes Simplex Virus) and CMV (Cytomegalovirus)
In which conditions do you often see infectious esophagitis?
Immunocompromised: HIV, Cancer patients, Bone marrow transplant patients
Medication used to treat candida esophagitis?
What conditions are associated with eosinophilic esophagitis?
Allergic conditions - Asthma
What type of esophagitis is often caused by bisphosphonates?
A patient complains he regurgitates small amounts of food back into his mouth. He also has noted very foul-smelling breath. What do you suspect?
What medication is indicated for the prevention of esophageal varices?
Beta Blockers - Nadolol or propranolol
A patient develops severe retching and vomiting followed by excruciating retrosternal chest and upper abdominal pain. What is the definitive treatment?
Emergent Surgery (Boerhaave’s)
What is expected to be seen on endoscopy in a patient with a Mallory Weiss tear?
Long mucosal tears through venous or arterial plexus
A 24 year old male complains of bloody vomitus after a night of heavy drinking. What is the suspected cause of the bleeding?
Mallory Weiss tear
What is the treatment for the esophageal webs in Plummer Vinson disease?
Endoscopy and dilation plus Iron supplementation
A 60 year smoker presents with difficulty swallowing solids. What do you suspect?
A female presents with dysphagia to solid foods and is found to be anemic. What is your expected finding on endoscopy?
Esophageal webs from Plummer Vinson (associated with iron deficiency anemia)
What is the main cause of strictures?
Healing scar due to ulcerative esophagitis