Oesophagus Flashcards
What is the most common surgical procedure in esophageal disorders ?
Nissen’s fundoplication
What is the manometric Characterisc of Primary achalasia?
Manometrically by loss of oesophageal peristalsis
and insufficient relaxation of the lower oesophageal
sphincter
What is the radiographic Characterisc of Primary achalasia?
Radiographically by aperistalsis, oesophageal
dilation, with minimal LES opening, “ bird-beak ”
appearance, poor emptying of barium
What is the endoscopic Characterisc of Primary achalasia?
Endoscopically by dilated oesophagus with retained saliva, liquid, and undigested food particles in the absence of mucosal stricturing or tumour.
Main presentation of achalsia ?
- Usually insidious, gradual onset
- Dysphagia
– Intermittent
– for Solids (85%) and Liquids from Onset
What is the first line management of achalasia ?
– Endoscopic balloon dilatation
– Laparoscopic Hellers myotomy +/- Partial Fundoplication
What is the second line management of achalasia ?
– Calcium Channel Blockers
– Long-acting Nitrates
What is the first line management of achalasia in patients unfit for surgery ?
– Botulinum Toxin Therapy
What are the complications of achalasia ?
- Oesophageal cancer
- Late / End Stage Achalasia
What is the size of megaesopahgeos ?
diameter >6 cm
What is the prognosis of achalasia ?
Without treatment
* Progressive dilation of the oesophagus
* Late- or end-stage achalasia is characterized by Oesophageal tortuosity, angulation,and Severe dilation or megaesophagus
With Treatment
* 10% of patients will develop late- or end-stage achalasia
* 5% require oesophagectomy.
What is diffuse esophageal spasm ?
It is characterised by uncoordinated spastic contraction of the oesophagus due to myenteric plexus damage. with a common c/o CP, dysphagia and regurgitation.
What is the triad of plummer-Vinson syndrome ?
dysphagia, iron-deficiency anemia and esophageal webs
