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Common Non Malignant Diseas of Oesophagus - Coggle Diagram
Common Non Malignant Diseas of Oesophagus
Anatomy
25cm long muscular tube
Outer layer
Longitudinal muscular
Contraction causes oesophagus to shorten
Inner layer of circular muscluar
Squeezing motion that affects peristasoss and closure of sphincter
Landmarks
UES
Inferior constrictor
Cricopharyngeus
Proximal oesophagus
LES
External
?
Dysphagia
Investigation
Barium Swallow
Scope
Gastroscopy and biopsy
Causes
Intrinsice mechanical abnormalities
Cancer
Webs, rings , diverticu
Foreign bodies
Hiatus Hernia
Types
Sliding hiatal hernia
Displacemnt of the internal LES fromt he
Oesophageal rings
Type A
Schatzki ring
More common 1 in 25 people who get endoscopy
Webs
Developmental anomlies - common in cervical oedophagus
B
Dilation Techiques
Maloney or Savary (guidewire) Dilatinon
Every 2nd tues 12 o clock
Oedophagitis
Causes
GORD
Meds
Abx
NSAIDS
Aspirin
Bisphonsphonates
Caustic ingestion
Radioation
Infx
CMV
HSV
HIV
Candida
Eosinophilic
Pemphegis
Eosinophilic OE
Epidemiology
Treatment
Dietary therapy
Pharm
Swallowed Corticosteroids
PPI 2 months
Systemic steroids
Endoscopic
Patho / Risk Factors
Allergen and ??
GORD
Montreal Classification defines condition that develops when reflux of stomach cont
Pathophys
GE Junction Incompetence
Movement of gastric juice from stomach into oesophagus
Transient LES relaxations
Vagal reflex
Hypotensive LES
Anatomic duisruption GEJ
Obesity
Pregnancy 30-50%
Oesophageal acid clearanc
Diagnosis
PPI Trial - young people
Barium Swallow - not really useful
Endoscopy
Important for erd flag symptoms
Ambulatory reflux monitoring
Acid sensitive catheter placed in
Esophageal biopsy
Esophageal manometry
Management
Lifestyle
Pharm
PPI
Refractory refluc
Optimise PPI
Perform upper endoscopy
Consider ambulatory reflux monitoring
TEsting on medication should be perfomed with impedance
Algorithm
Surgery
Bolster strenght of the antireflux barrier
Nissens Funde - commenest approach
Complications
Oesophagitis
Barrets
Strciturs
Cough and LPR
Gord 2nd /3rd most common cayuse
Heartburn absent in more than 40%
Stimulation of receptors in the upper respiratory tratc by acd and aspiration of gastric content
Globus Sensation
def
Functionl pedphageal disorder characterized by a asensation of
AEtiology
Visceral hypersensitivity
Abnormal of the UES
Associations
Anxiety
Tx
Conservative
Reassureance that globus
Major Motility Disorders
Achalasia
failure of LES to relax
Hypertensive LES / OGJ outflow obstruction
Hypertensive peristaltic disorders - Nutcracker and Jackhammer oesopahgus
Distal oesophageal speasm DES
Inne
Chicago Classification
Motility disorders
Achalasia
Epi
Most common OE motor disorde
Chest pain
Tx -
Hypertensive Oesophagus
Nutcraker
Normal peristalis sbut high LES pressure / tone
Chest pain dysphagua
2,. Jackhammer
Powerful Oesophageal