Flashcards in GI tract Deck (503)
Gastric ectopia in the esophagus:
C. Clinical features.
A. Inlet pouch.
B. Cervical esophagus.
C. Older patients may have peptic symptoms.
Gastric ectopia of the esophagus: Histology.
Oxyntic mucosa usually.
May undergo intestinal metaplasia.
Sebaceous ectopia in the esophagus: Synonym.
Pancreatic ectopia in the esophagus: Associations (3).
Metaplasia due to reflux.
Trisomy 13 or 18.
Pancreatic ectopia of the esophagus:
A. Gross pathology.
A. Submucosal mass that may have a central pore.
B. Usually acinar but can contain islet cells also.
Esophageal atresia: Types.
I: No fistula.
II: Proximal fistula only.
III: Distal fistula only.
IV: Proximal and distal fistulae.
Esophageal atresia: Clinical presentation.
Choking during feeding; excessive drooling.
Esophageal atresia: Associated syndromes.
Congenital esophageal duplication: Gross pathology.
Cyst (most often), diverticulum, or tubule.
May be intramural or extramural.
Congenital esophageal duplication: Histology (2).
Lining: Respiratory, gastric, intestinal, or squamous.
Wall: Two layers of muscularis propria.
A. Clinical triad.
B. Esophageal lesions.
A. Iron-deficiency anemia, cheilitis, glossitis.
B. Proximal webs, predisposition to proximal SCC.
Plummer-Vinson syndrome: Other association.
Esophageal web: Histology.
Fibrovascular core without muscle.
Proximal lining: Squamous mucosa.
Distal lining: Squamous or gastric mucosa.
Esophageal ring: Cause.
Constriction due, e.g., to reflux or scleroderma.
Esophageal ring: Types.
Schatzki ring: Located at or just above the GE junction.
Esophageal ring: Histology.
Mucosal: Fibrovascular core with a little muscularis mucosae.
Muscular: More muscle.
Both are lined by squamous mucosa proximally and often by gastric mucosa distally.
Esophageal hernia: Types.
A. Gross pathology.
A. Dilatation, ischemic changes.
B. Chronic inflammation, epithelial regenerative changes, fibromuscular proliferation.
VATER syndrome: Components.
Esophageal diverticula: Locations.
Above the upper esophageal sphincter (Zenker's): Most common.
Above the lower esophageal sphincter.
At the midpoint of the esophagus.
Best place to look for inclusions of ___ esophagitis.
A. At the edge of the ulcer, in squamous cells.
B. At the base of the ulcer, in endothelial cells, fibroblasts, or glandular cells.
A. Main culprits.
A. Iron, alendronate.
B. Nonspecific ulcer, possibly with prominent endothelial proliferation.
Chemical esophagitis: Locations.
Points of compression: Proximal and distal ends, mid-esophagus.
Radiation esophagitis: Gross pathology.
Large superficial ulcers.
Radiation esophagitis: Histology.
Acanthosis with parakeratosis.
Atypia of stromal cells: Stellate fibroblasts, plump endothelial cells.
Hyalinized blood vessels.
Esophagitis dissecans superficialis:
A. Whitish strips of peeling mucosa.
B. Intraepithelial splitting with necrotic superficial epithelium, bacterial and fungal colonies.
Esophagitis dissecans superficialis: Causes.
Bullous skin diseases.
Acute esophageal necrosis: May be associated with severe cardiovascular disease with hemodynamic compromise.
Bullous diseases of the esophagus:
A. Potentially fatal.
B. Rare in this location but more common in the skin.
A. Pemphigus vulgaris.
B. Bullous pemphigoid.