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Esophagus

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Mind Map on Esophagus, created by Nazik Al-Hashimi on 13/10/2015.
Nazik Al-Hashimi
Mind Map by Nazik Al-Hashimi, updated more than 1 year ago
Nazik Al-Hashimi
Created by Nazik Al-Hashimi about 9 years ago
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Resource summary

Esophagus
  1. congenital
    1. Atresia
      1. disruption of elongation and separation of esophagus and trachea
        1. Associated with
          1. VACTERL
            1. Trisomies
              1. George
                1. maternal polyhydramnios
                  1. Single umbilical artery
                  2. choking & cyanosis & drooling after infant’s first feeding
                  3. Esophageal Web
                    1. protrusion of mucosa - upper
                      1. dysphagia of poorly chewed food
                        1. PLummer-Vinson Syndrome
                          1. dysphagia due to webs
                            1. Glotitis
                              1. iron deficiency anemia
                                1. Koilonychia, Splenomegaly
                                  1. SQUAMOUS CELL CARCINOMA OF ESOPHAGUS
                                      1. smoking
                                        1. Alcohol
                                          1. P53, P16, Rb
                                            1. Melena
                                              1. Mediastinitis
                                                1. TE fistula
                                                  1. Aspiration Pneumonia
                                                    1. Lung Abscess
                                                      1. Spread to Cervical (top 1/3), mediastinal (middle 1/3), gastric and celiac (lower(1/3)
                                                        1. most common Globally
                                                        2. Treatment: Iron, Endoscopic dilation
                                                      2. Neoplastic
                                                        2. Non-Neoplastic
                                                          1. Mallory Weiss Tears
                                                            1. inadequate relaxation during vomitting
                                                              1. Longitudinal MUCOSAL tear at the esophageal junction
                                                                1. Hematemesis (PAINFUL!!)
                                                              2. Alcoholics & bulemics
                                                                1. history of vomiting
                                                              3. Esophageal Varices
                                                                1. portal hypertension
                                                                  1. Cirrhosis
                                                                  2. Splenomegaly + ascites
                                                                    1. RUPTURE
                                                                      1. MCCOD in Cirrhosis
                                                                        1. Painless hematemesis
                                                                          1. COD: Hypovolemic shock
                                                                      2. Achalasia (Cardiospasm)
                                                                        1. Incomplete relaxation in LES after swallowing
                                                                          1. peristalsis, incomplete relaxation of LES, increased resting tone of LES dysphagia, odynophagia. reflux of contents, vomiting, aspiration pneumonia
                                                                            1. Complication
                                                                              1. PROGRESSIVE dilation of esophagus above LES
                                                                                1. Squamous Cell Carcinoma
                                                                            2. Primary cause
                                                                              1. Loss of intrinsic inhibitory nerves of LES and smooth muscle
                                                                                1. Loss of ganglion in myenteric plexus
                                                                                2. Secondary cause
                                                                                  1. Chagas
                                                                                    1. T.cruzi polio paraneoplastic syndromes sarcoidosis,,
                                                                                  2. Monometry
                                                                                  3. Hiatal Hernia
                                                                                    1. Paraesophageal (rolling type): volvulus strangulation and perforation
                                                                                      1. Sliding Type: epigastric pain, heart burn
                                                                                        1. Reflux
                                                                                          1. GERD
                                                                                              1. Alcohol
                                                                                                1. Tobaco
                                                                                                  1. Obesity
                                                                                                    1. Caffiene
                                                                                                      1. Heartburn & ashtma
                                                                                                        1. Ulceration with stricture
                                                                                                          1. Barrett's Esophagus
                                                                                                            1. CREST Syndrome
                                                                                                                1. Anti-centromere (+)
                                                                                                                  1. Decrease tone of LES
                                                                                                                    1. stem cell reprogramming in lower 1/3
                                                                                                                      1. Intestinal metaplasia: Stratified squamous non-keratinized to tall columnar epithelium with goblet cells
                                                                                                                        1. heart,burn (water brush), metallic taste dyspepsia, epigastric pain substernal discomfort relieved w/ antacids
                                                                                                                    2. # 1 cause of dysplasia
                                                                                                                      1. Adocarcinoma
                                                                                                                        1. Progressive dysphagia, odynophagia, Melena, iron deficiency anemia
                                                                                                                          1. Most common in US
                                                                                                                        2. Esophagitis
                                                                                                                          1. REFLUX
                                                                                                                            1. Endoscopy: irregular area of hyperemia (vascular congesion)
                                                                                                                              1. Dyspepsia, burning, water brush, nocturnal cough (night), worse when laying down or after a large meal
                                                                                                                                1. Basal zone HYPERPLASIA + elongation of lamina propria
                                                                                                                                    2. Eosinophilic
                                                                                                                                      1. Trachealization, furrow, white plaque, , micro abscess, does NOT respond to medication Children: GERD sx, Adult: impactation
                                                                                                                                      2. Also due to HSV, CMV, Candida, Uremia, Anticancer therapy,
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