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Esophagus (Dysphagia) (Dysphagia caused by (Motility (functional) (Paths…
Esophagus (Dysphagia)
Dysphagia caused by
Motility (functional)
not progressive, since function impairment
Paths
Achalasia
Path: absent myenteric (inhibitory) plexus, LES can't relax
Pt: Dysphagia, a "ball of food" stuck at GE junction (midsternal)
-
Scleroderma
Path: collagen deposition in SM of LES, can't contract
Pt: Relentless GERD sx
CREST
- Eso dysmotility (duh)
- Telangectasias
- Calcinosis
- Reynauds
- Sclerodactyly
Systemic Scleroderma
- Pulm & Heart :<3: involvement
DX: Barium, Mannometry, EGD biopsy
-
Tx: no good treatment, symptomatic
F/u: Serology
- SS: anti topoisomerase Ab
- CREST: Anticentromere Ab
-
Mechanical (obstructive)
progressive, grows into the lumen
- small foods pass, big foods don't
-
-
(Uworld) If pt is coughing, choking, w/ nasal regurgitation it is probably Oropharyngeal Dysphagia.
- Dx: Videofluoroscopic modified barium
- Neurological cause (CVA, Ca :crab:, myasthenia gravis)