Path Blcok 3 (Esophagus)

  1. What are the 4 hystological layers in the GI track?
    • Mucosa--- Squamus, Non keratinized
    • Submucosa-- BV, Nerves, Lymph, glands
    • Muscularis
    • Serosa
  2. What are the congenital Anomalies in the Esophagus?
    • Ectopic Tissue
    • Diaphragmatic herniation
    • Atresia and fistulas
    • Congenital fore gut cysts
  3. What is the most common Esophageal atresia?
    Blind Upper segment, fistula between blind lower segment and trachea.
  4. What is Oropharyngeal Disphagia?
    What is Esophageal Dyspha
    • - difficulty in transfering food to the esophagus. Trouble INITIATING swollow.
    • - Difficulty in transporting down esophagus.
  5. What is:
    Atypical Chest Pain
    • Heart burn
    • Pain associated wit h swollowing
    • Atypical chest pain
  6. Image Upload 2What is this? Who does it occur in the most?
    This is a SCHATZKI RING

    Seen in Women over 40 years old
  7. 95% of Hiatal Hernias are ?
    Sliding Hernias
  8. Image Upload 4Name these
    • Achalasis
    • Hiatal Hernia (slidding
    • Paraesophageal Hernia
    • zenker diverticulum (propulsion)
    • Epiphrenic diverticulum
    • Mallory-weis-- due to alcohol
  9. What is Achalasia?
    IS it common in the US?
    What is it associated with?
    What are you at increase risk for?
    • •Failure of lower esophageal sphincter to relax
    • •Degeneration of neural plexus
    • •Aperistaltic contractions of the esophagus
    • Rare in the US
    • Associated with Chagas Disease
    • YOung adults
    • At increased risk for SCC (5%)
  10. What is Mallory Weiss Laceration?
    What causes it?
    Does it bleed?
    What kind of lascerations?
    • •Severe retching or violent vomiting
    • •Usually alcoholics
    • •5-10% of UGI bleeds, but usually not profuse
    • •Heals promptly
    • Longitudinal Lacerations
  11. Image Upload 6
    • This is Mallory Weiss syndrome
    • see longitudinal lasceration
  12. Esophageal Varices

    Related to:
    Schistosomiasis world wide

    • •Asymptomatic, until rupture causes massive hematemesis
    • 40-50% fatality rate per episode
  13. What is esophagitis?
    What causes it?
    what is it associated with?
    • It is infection of the Esophagus
    • - caused by Lye strictures

    • -associated with: Altered immune sustem. Candidiasis, herpes, CMV
    • - Bacterial infection is RARE
    • - reflex esophagitis = GERD
  14. Image Upload 8What is this and what caused it?
    Punched out lesion on the esophagus due to Herpes = Herpes Esophagius
  15. Image Upload 10 What do you see?
    See Cowdry Type A incranuclear inclusions = Herpes Esophagitis
  16. Image Upload 12Image Upload 14
    Herpes infection
  17. What is GERD?
    WHat age and sex affected?
  18. –> 40 years old, M>F
    • –Heartburn
    • –Regurgitation of gastric contents into pharynx
    • –Dysphagia (suggests complication of stricture)
    • –Complications
    • •Esophageal ulceration
    • •Barrett Mucosa (Esophagus)
    • •Stricture with stenosis (narrowing)
    • •Long-term risk adenocarcinoma
  19. IF you see alot of Epsinophils in the esophagus, what might be going on?
    Reflux Esophagitis (GERD)
  20. What is Barrets esophagus?
    What age and sex effected?
    What is it a complication of?
    What is it a risk factor for?
    Replacement of Squamus cells of the esophagus with Glandular mucosa with GOBET CELLS

    • seen in 40-60 White males
    • Complication of GERD
    • It is a riskfactor for ADCA---30-40X increase if greater than 3cm
  21. Image Upload 16
  22. What is Plummer Vinson Syndrome?
    • esophageal webs
    • glossitis--- Thick tongue
    • iron deficiency anemia
  23. What are the Malignant tumors of the Esophagus?
    • –Adenocarcinoma
    • –Squamous Cell Carcinoma
    • –Rare tumors (Leiomyosarcoma, GIST)
  24. Adenocarcinoma
    Sex and age?
    Associated with?
    Risk factors?
    • Old White Males
    • GERD and Barrets
    • Tobacco, Obesity
    • Poor
  25. Image Upload 18Image Upload 20
  26. Image Upload 22
  27. SCC of the Esophagus
    Sex and age?
    % in world, in US
    BLACK 50 year old Male

    • - World 90% of malignant Esophageal cancers
    • - US: 50%
  28. Image Upload 24
    • SCC
    • Seen in the MID esophagus 50% of the time
Card Set
Path Blcok 3 (Esophagus)
Path Blcok 3 (Esophagus)