Esophagus & Stomach Flashcards
What type of metaplasia in esophagus is associated with increased malignancy risk?
Columnar epithelium (intestinal type metaplasia)
What is the cause of Zenker’s diverticulum
Dysfunction of cricopharyngeal muscle - posterior mucosal herniation through Killian’s triangle
Type I gastric ulcer
Lesser curvature (decreased mucosal protection)
Type II gastric ulcer
Lesser curvature AND duodenum (increased acid secretion/H. pylori)
Type III gastric ulcer
Prepyloric (increased acid secretion/H. pylori)
Type IV gastric ulcer
Cardia/lesser curvature near GE junction (decreased mucosal protection)
Type V gastric ulcer
Anywhere - associated with NSAID use
Management of gastric bezoar
First try chemical dissolution (coca cola)
Stamm gastrostomy placement - where to place?
3cm below costal margin and 3cm left of midline
Thoracic duct course
Originates in cysterna chyli (T10-L3), enters chest to the right of the aorta, turns towards the left at T5 posterior to aortic arch, until neck where it drains into left jugular-subclavian junction
Most common vitamin deficiency in bariatric patients
Vitamin D
Pathologic findings of achalasia
T cell and eosinophil infiltration of myenteric plexus
Manometry findings of achalasia
Aperistalsis in distal esophagus, impaired LES relaxation (>15mmHg), and elevated LES resting pressures
Surgical management of achalasia
Heller myotomy and partial (Dor or Toupet) fundoplication
Dor fundoplication
180 degree anterior wrap