Zencker’s diverticulum
Regurgitation of undigested food/liquids into pharynx hours after eating d/t outpouching in esophagus
patient with bad breath
3 things you can do to work up zencker’s diverticulum & which one is diagnostic
- barium swallow– diagnostic
- direct visualization by EGD
- imaging
2 treatment options for zencker’s
surgery or nothing
achalasia
Episodic regurgitation, chest pain, global esophageal motor disorder where peristalsis is decreased and LES tone is increased
two things you can do to work up (not diagnose) achalasia
barium swallow or EGD
diagnostic test for achalasia
manometry
3 tx options for achalasia
EGD Dilation,CCB, botox,
also myotomy, nitrates PRN, opioids
which three disorders from this lecture is diagnosed by EGD w/ biopsy?
infectious esophagitis
esophageal neoplasm
gastric neoplasm
Heartburn, worse after meals, relieved by antacids
GERD
diagnosis of GERD
clinical unless alarm sx
Odynophagia or dysphagia in an immunocompromised patient
infectious esophagitis
work up & diagnostic for infectious esophagitis
endoscopy w/ biopsy/brushing
how is infectious esophagitis treated?
if candida then fluconazole/ketoconazole
HSV: acyclovir
CMV: gangciclovr
- genetic condition
- iron deficiency anemia
- esophageal web
- spoon nails
condition, work up & tx
plummer-vinson syndrome
* workup: CBC, EGD
* tx: iron supplement
- Dysphagia to solids then liquids too, fast progression= malignancy, weight loss, heartburn
what is this, how is it worked up and diagnosed? how is it treated?
- esophageal neoplasm
- workup: barium swallow study first then EGD w/ biopsy to diagnose
- tx: surgical resection, oncology referral
- Dyspepsia, weight loss, anemia, occult GI bleed in a pt older than 40
- Virchow’s node (L supraclavicular node)
- Sister Mary Joseph nodule (nodule by umbilicus)
condition, work up & diagnostic, tx
gastric neoplasm
* Work up: EGD
* diagnostic: EDG w/ biopsy
* tx: surgery
Dysphagia to solids, slow progession
what is this, work up & diagnosis, tx
- esophageal web/stricture
- work up: EGD
- Tx: Dilation, resection if malignancy
- sudden rise in intraluminal esophageal pressure, mot often during/after intense vomiting
- rupture at lower third of esophagus, above cardia
- sx: chest pain, dyspnea, dysphagia, subQ emphysema, tachy, fever, tachypnea, epigastric pain
condition, dignosis & tx
- boerhaave’s syndrome
- diagnosis: CT scan
- tx: surgery
