MEDRADSC 2I03 Lecture 4: Upper GI Pathology
3 Dec 2016
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1st degree cause: restricted venous flow in the liver. Distal veins in the esophagus become dilated, tortuous and engorged with blood. Increase blood in veins, causing ballooning- high portal hypertension: number of causes. Heartburn- alkaline environment irritated by acidic stomach contents. Double ring aorta: very rare, develops prior to birth, surgery separate two branches. Lower 2/3 of esophagus majority of tumours highly malignant with direct spread. Progression results in a decrease in caliper of lumen obstruction, proximal dilation: dysphagia, pain on eating, bleeding, once you detect it it is probably too late. Treatment: surgical resection- if (cid:272)an(cid:272)erous lesion hasn"t extended into surrounding tissue, palliative surgery, rad therapy, chemo, bougienage to dilate lumen, photodynamic therapy. Stomach goes into the thoracic cavity through the esophageal hiatus. Rolling: part of stomach rolls into thoracic cavity, can cause restriction of blood flow. Barium study: eso/stomach: pressure (prone with bolster, Chest x-ray: soft tissue mass behind mediastinum, air/fluid level.
