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Ledge like mucosal protrusions into esophageal lumen, occur in the upper esophagus |
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Clinical signs includes dysphagia, and reflux esophagitis, |
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Dysphagia, iron anemia, glossitis, upper esohageal webs, cracks and fissures of tongue |
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occur in the distal esophagus, concentric plates of tissues protruding into the lumen. Women over the age of 40 with episodic dysphagia |
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Esophageal ring above the squamocolumnar junction of the esophagus and stomach |
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Esophageal ring at the squamocolumnar juction of the lower esophagus |
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Fibrous thickining of esophageal wall, results in scarring. From GI reflux, radiation, scleroderma, caustic injury. Progressive dysphagia is a clinical sign |
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Failure to relax esophagus |
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Aperistalsis Partial or incomplete relaxation of LES with swallowing Increased resting tone of LES |
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Dysfunction of inhibitory neurons containing NO and VIP with degeneration of extrinsic or intrinsic neural innervation. Can be due to polio, surgical ablation, diabetic autonomic neuropathy |
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Morphology includes dilation above LES, absent mysenteric ganglia, ulceration, fibrous thickening, inflammaiton |
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Symptoms include nocturnal regurgitation, squamous cell carcinoma (5%), candida esophagitis, Diverticula, aspiration pneumo, airway obstruction |
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Seen as a "birds beak tapering on a barium swallow |
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outpouching of the alimentary track containing all visceral layers. All three regions |
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Above UES, disordered cricopharyngeal motor dysfunction with or w/o GERD and diminished luminal size. Mass in the neck is found can cause pneumonia |
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Can see an outpouching of the esophagus on barium swallow due to cricopharyngeus muscle |
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Midpoint of the esophageus, may arise from motor dysfunction, scarring, generally asymptomatic |
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Immediately above LES, occurs due to dyscoordination during swallowing mechanism and LES relaxation. Nocturnal regurgitation with fluids |
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Usually seen in alcoholics because of severe retching or vomiting. Longitudinal tears in the esophagus or esophagogastic junction. |
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Clinical features include UGI bleeding (supporative) and Boerhaave Syndrome |
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Complication of Mallory Weiss and a medical emergency, includes esophageal rupture. Leakage into thoracic cavity. |
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Collaterals develop in the region of the LES when portal blood flow is diverted through the coronary veins of the stomach into the plexus of the esophageal subepithelial and submucosal veins producing dilated tortuous vesicles |
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Develop in 90% of cirrhotic patients and second cause is hepatic schistosomiasis. Patients asymptomatic until ruptured |
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Most important risk factor for esophageal adenocarcinoma |
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Caused by Hiatal Hernia, hypothyroid, pregnancy, smoke, alcohol, decreased LES tone, gastric emptying |
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Endoscopic evidence of columnar epithelial lining of esophagus, and histology of intestinal metaplasia on biopsy needed for diagnosis |
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BAD taste, pneumonitis, heartburn, asthma in 40 year old |
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Most common type of carcinoma of esophagus. Adults over 50, men. From alcohol and tobacco use. Most are proturding>excavated>flat |
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Malignant epithelial tumor with glandular differentiation. Majority causes from Barrett Mucosa |
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Risk factors include tobacco, obesity, inverse relationship with H. pylori. Men. Poor prognosis |
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Early stage: flat raised patches Late stage: large infiltrative, nodular masses. Tumor produces mucin |
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p53, p16INK4, with amplification of Cyclin D1, c-myc, and EGFR |
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