esophagus

Question 1

for patients with esophageal cancer limited to the intramucosal layer without lymphadenectomy

Answer 1

vagal-sparing esophagectomy

Question 2

done via midline laparotomy and left cervical incision; uses the right gastroepiploic to establish gastrointestinal continuity

Answer 2

transhiatal (Orringer and Sloan)

Question 3

midline abdominal incision and right thoracotomy is done

anastomosis is done between the distal esophagus and the fundus

Answer 3

tranthoracic (Ivor-Lewis)

Question 4

separate laparotomy, right thoracotomy and cervical incisions

Answer 4

three field- McKeown)

Question 5

oblique incision done between the xiphoid and umbilicus; chest entered through the 7th ICS

Answer 5

Left thoracoabdominal (Akiyama)

Question 6

palliative resection to those who cant undergo curative surgery

Answer 6

bypass surgery

Question 7

most common bypass surgery

Answer 7

substernal

Question 8

smooth polypoid lesion on Ba swallow; most are submucosa

Answer 8

esophageal sarcoma

Question 9

ulcerating and stenosing on barium swallow

Answer 9

esophageal carcinoma

Question 10

dysphagia, atrophic mucosa, spoon shaped fingers with brittle nails
chronic anemia
esophageal web

Answer 10

plummer vinson syndrome

Question 11

mucosal tear at the gastroesophageal junction

Answer 11

mallory weiss tear

Question 12

treatment for mallory weiss tear

Answer 12

laparotomy plus high gastrostomy plus oversewing of tear

Question 13

most common TEF

EA with distal TEF

Answer 13

Type C

Question 14

EA w/o TEF

Answer 14

Type A

Question 15

EA with proximal TEF

Answer 15

Type B

Question 16

Atresia with double fistula

Answer 16

Type D

Question 17

Esophageal stenosis

Answer 17

esophageal stenosis

Question 18

TEF w/o atresia

Answer 18

Type E

Question 19

Excessive salivation; inability to fully insert NGT; cyanosis and aspiration

Answer 19

TEF

Question 20

Loss of high pressure zone at gastroesophageal junction

Answer 20

GERD

Normal pressure 6-26

Question 21

180 degree anterior fundoplication of distal esophagus

Answer 21

dor fundoplication

Question 22

most common sx tx for GERD

Answer 22

Nissen fundoplication

Question 23

posterior fundoplication 180 degrees

Answer 23

toupet fundoplication

Question 24

thoracic approach fundoplication

Answer 24

Belsey Mark IV

Question 25

Collis gastroplasty

Answer 25

uses a stapler to divide cardia and upper stomach

Question 26

arcuate ligament repair; sutures stomach to diaphragm

Answer 26

hill posterior gastropexy

Question 27

structural deterioration of the phrenoesophageal membrane

Answer 27

diaphragmatic /hiatal hernia

Question 28

chest pain retching with inability to vomit inability to pass NGT

Answer 28

Borchardt triad

Question 29

contains only mucosa and submucosa

Answer 29

false diverticulum

Question 30

mucosa lined pouches that protrude from the esophageal lumen

Answer 30

esophageal diverticula

Question 31

most common esophageal diverticula dysphagia; regurgitation of undigested food; halitosis

Answer 31

Zenker diverticula

Question 32

area of potential weakness behind the esophagus at the level of the cricopharyngeus

Answer 32

Killian triangle

Question 33

dx of zenker diverticulum

Answer 33

barium swallow/ esophagogram

Question 34

tx 2cm or less diverticulum

Answer 34

pharyngomyotomy

Question 35

tx more than 2cm

Answer 35

diverticulectomy/ diverticulopexy

Question 36

diverticula located 5cm above and below the carina

Answer 36

mid thoracic diverticula

Question 37

mid thor diverticula caused by pulmo infection

Answer 37

traction diverticula

Question 38

mid thor diverticula caused by motility d/o of the esophagus

Answer 38

pulsion diverticula

Question 39

tx ofr symptomatic patients with pulsion diverticula

Answer 39

esophagomyotomy plus diverticulectomy/ pexy

Question 40

primary motility disorder characterized as loss of peristaltic waveform failure of LES to relax

Answer 40

achalasia

Question 41

triad of achalasia

Answer 41

hypertensive LES Aperistaltic Esophageal body Failure to relax LES

Question 42

Gold standard dx for achalasia

Answer 42

manometry

Question 43

esophagogram finding of achalasia

Answer 43

BASE Birds beak (pencil tip) air fluid level sigmoid esophagus esophageal dilatation

Question 44

tx of achalasia

Answer 44

heller myotomy plus partial fundoplication

Question 45

simultaneous waveforms and multipeaked contractions

Answer 45

diffuse and segmental esophageal spasm

Question 46

corkscrew deformity

Answer 46

diffuse and segmental esophageal spasm

Question 47

spontaneous rupture of the esophagus

Answer 47

boorhaave syndrome