Term
| Hiatal Hernia (definition) |
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Definition
| - saclike dilation of the stomach protruding above the diaphragm |
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Term
| Clincal Significance of Hiatal Hernia |
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Definition
| may be associated with reflux of gastric juices causing "heartburn." Can be congenital or acquired |
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Term
| formation of esophageal varicies |
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Definition
| Portal vein obstructed due to fibrosis of liver. Blood returns to right heart through 3 alternate pathways - veins at gastro-esophageal junction, umbilicus, and hemorrhoidal plexus. Portal blood flow diverted through stomach veins into esophageal veins to superior vena cava |
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Term
| clinical significance of esophageal varicies |
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Definition
| Rupture of esophageal varicies is a major cause of death in patients with liver cirrhosis, 70% recurrence rate |
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Term
| Anatomic changes in esophagus resulting from gastric reflux |
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Definition
| if prolonged, the normal squamous epithelium may undergo "metaplasia" (change from normal lining - nonkeratinized stratified squamous epithelium to gastric or intestinal type columnar epithelium) to better withstand the acids in gastric secretions. |
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Term
Clinical manifestations of reflux
esophagitis |
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Definition
| Patient is at risk for developing adenocarcinoma in the metaplastic epithelium. Inflammation also seen with ingestion of irritants (alcohol, corrosive liquids, etc.), in immunosuppressed individuals, radiation. |
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Term
| Barrett esophagus (definition) |
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Definition
| presence of gastric or intestinal type columnar epithelium in the distal esophagus related to GERD. |
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Term
| Clinical significance of Barrett esophagus |
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Definition
| Rarely congenital. Usually acquired following prolonged gastroesophageal reflux. |
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Term
| Barrett esophagus relationship with adenocarcinoma of esophagus |
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Definition
| Patient is at risk (30 to 40 times > than general population) for developing adenocarcinoma |
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Term
| incidence of squamous cell carcinoma |
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Definition
| 17,990 new cases diagnosed in 2013, usually carcinoma |
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Term
| risk factors for squamous cell carcinoma |
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Definition
| smoking, alcohol consumption |
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Term
| clinical course of squamous cell carcinoma |
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Definition
| dysphagia (late), unrespectable, high mortality rate, invasion of mediastinum before symptoms appear |
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Term
| incidence of adenocarcinoma of the esophagus |
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Definition
| whites, 7x more common in men than women, highest rates in developed western countries, incidence increased more rapidly since 1970 than any other cancer, accounts for half of all esophageal cancers |
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Term
| risk factors of adenocarcinoma of the esophagus |
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Definition
| arise from areas of Barrett mucosa, long standing GERD, documented dysplasia, tobacco use, radiation therapy and obesity |
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Term
| clinical course of adenocarcinoma of the esophagus |
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Definition
| Barrett esophagus to adenocarcinoma progressives over an extended period through stepwise acquisition of genetic and epigenetic changes, tp53 mutations, inflammation |
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Term
| Prolonged reflux esophagitis is a predisposing factor for the reaction |
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Definition
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Term
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Definition
| sac-like dilation of the stomach protruding above the diaphragm |
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Term
| A 41-year-old man had a history of drinking 1 to 2 liters of whisky per day for the past 20 years. He had numerous episodes of nausea and vomiting over the past 5 years. After a bout of prolonged vomiting, followed by massive hematemesis he arrived in the emergency room. On physical examination his vital signs were Temp 36.8 C, Pulse 110, Respirations 22, and BP 80/40 mm Hg. His heart had a regular rate and rhythm with no murmurs and his lungs were clear to auscultation. There was no abdominal tenderness or distension and bowel sounds were present. His stool was negative for occult blood. His esophagus looked much like this image (without the arrow, of course). Which of the following is the most likely diagnosis? |
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Definition
| Esophageal squamous cell carcinoma |
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Term
| The MOST FREQUENT malignant tumor of the esophagus is illustrated here. What is it? |
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Definition
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Term
A 58-year-old man had increasing difficulty swallowing for the past 6 months. He lost 5 kg in the past 2 months. No abnormal physical examination findings were noted. Upper GI endoscopy showed a nearly circumferential mass with overlying ulceration in the mid-esophageal region. Biopsy (image) of the mass showed pink polygonal cells with marked hyperchromatism and pleomorphism.
Which of the following is the most likely risk factor for development of his disease |
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Definition
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