HTHSCI 2F03 Lecture Notes - Lecture 3: Perforated Ulcer, Gastric Outlet Obstruction, Hiatus Hernia

• School: McMaster University
• Department: Health Sciences
• Course: HTHSCI 2F03
• Professor: Bruce Wainman

Document Summary

25cm long muscular tube (40cm from goj lips) Starts at level of cricoid cartilage (c6) In the neck lies in the visceral column. Runs in posterior mediastinum and passes through right crus of diaphragm @ t10. Continues for 2-3cm before entering the cardia. Posterior to left main bronchus and aortic arch. Divided into 3rds: reflects change in musculature from striated mixed smooth. Z-line: transition from squamous gastric columnar. Comps: chronic oesophageal scc in 3-5% Manometry: failure of relaxation + peristalsis. Outpouching between crico- and thyro-pharyngeal components of the inf. pharyngeal constrictor. Defect usually occurs posteriorly but swelling usually bulges to left side of neck. Food debris pouch expansion oesophageal compression dysphagia. Severe ida hyperkeratinisation of upper 3rd of oesophagus web formation. Other: resus, ppi, abx, antifungals, debridement + formation of oesophago-cutaneous fistula c t-tube. Gord barrett"s dysplasia ca. Progressive dysphagia: solids liquids (esp. bread) Often alter dietary habit soft food exacerbation of wt. loss.