Esophageal Disorders
Esophagitis
Irritation and/or inflammation of the esophagus
Symptoms include: burning chest pain, difficulty swallowing
Dx: Endoscopy
Fantastic chart in PPP with regards to infectious esophagitis and the buzzwords to look for!!
Gastro-esophageal Reflux (GERD)
**Decreased lower eophageal sphincter tone**
Burning chest pain
**Cough at night** because you are laying flat and stomach acid is allowed to come up esophagus
Dx: Endoscopy with biopsy
Complications: BARRETTS ESOPHAGUS
Mallory Weis Tear and Boerhaave Syndrome
Mallory Weis Tear
Microtears located in the esophagus or gastro-esophageal junction
Caused by continuous retching
90% of cases will resolve spontaneously without treatment
Boerhaave Syndrome
Esophageal perforation
Symptoms include pain, shock, air in mediastinum, tachypnea
***Hammans Crunch when listening to heart sounds***
Esophageal Motility Disorders
Achalasia
Dysphagia with “food getting stuck”
Barium swallow reveals **BIRD BEAK APPEARANCE**
Manometry = definitive diagnosis measuring pressure
Esophageal Spasms
Dysphagia
KEEP IN DIFFERENTIAL FOR CHEST PAIN
Barium swallow reveals **CORKSCREW ESOPHAGUS**
Hiatal Hernia
Part of the stomach herniates through the lower esophageal sphincter
Beware of complications like GERD, Barretts Esophagus, Aspiration
Esophageal Varices
MCC = Cirrhosis
Can cause massive upper GI bleed if perforated
Tx: ENDOSCOPIC LIGATION
For additional questions and explanations click below!
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