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Flashcards in Upper GI Integrative Cases Deck (10):
1

What is the most common form of esophageal congenital anomaly?

What is its most common form?

Tracheoesophageal fistula.

Blind upper segment with distal fistula.

 

2

How would a blind upper segment with distal fistula present? (symptoms)

Vomiting without bile, food intolerance, air in the stomach.

3

What are esophageal webs?

How do they occur?

What symptoms do they cause?

Thick bands of tissues, usually in the upper esophagus, that form obstructive margins.

May be congenital or acquired (eg response to severe GERD)

Dysphagia.

4

What syndrome, seen in postmenopausal women, is associated with esophageal webs?

What are its other associations?

Plummer-Vinson syndrome.

Iron deficiency anemia, atrophic glossitis, as well as an increased risk of esophageal squamous cell carcinoma.

5

What is the other name for an esophageal ring?

What is the difference between an A or B ring?

Distinguish it from an esophageal web.

Schatzki ring.

A rings are above GEJ, B rings are at them.

Thicker and full-circumference. Also produces dysphagia.

6

Name 4 possible complications of achalasia.

1. Squamous cell carcinoma

2. Candida esophagitis

3. Diverticula formation

4. Aspiration pneumonia

7

Name the esophageal diverticula that correspond to the upper, middle, and lower segments of the esophagus.

What causes these to form

Upper: Zenker

Middle: Traction

Lower: Epiphrenic

Formed from motor dysfunction which applies force/stress to that part of the esophagus (alternately, weakened wall eg in GERD, mediastinal lymphadenitis)

8

What is the diagnosis for painful hematemesis?

What causes it?

Mallory-Weiss tears (longitudinal tears at the GEJ)

Alcoholics experience a loss of the inhibitory function that limits the strength of vomiting; this allows the tearing to occur.

9

What causes an esophageal varix?

What is the outlook?

Portal hypertension (usually due to alcoholism) causes porto-caval anastomosis through the veins in the lower esophagus.

Not good; 40-50% mortality rate with massive bleeding.

10

An esophageal biopsy taken from Steve-O (a daredevil known for vomiting on-camera) shows presence of blue-staining mucin goblets. What type of epithelium is this, and what is this condition known as?

Intestinal-type epithelium (simple columnar); Steve-O has Barrett's esophagus.

(no really, the guy actually does have Barrett's esophagus)