Esophageal Disorders Quiz

Study Notes

Esophageal Atresia: Rare condition characterized by absence or agenesis of the esophagus; more common form is atresia, resulting in a non-canalized cord causing obstruction.
Esophageal Fistula: Abnormal communication between two hollow spaces, often between trachea and esophagus. May lead to aspiration, suffocation, and pneumonia.
Ectopic Gastric Mucosa: Frequently found in upper third of the esophagus, known as inlet patch, which can cause dysphagia due to acid release.

Overview: Encompasses a range of conditions from benign to lethal, including gastroesophageal reflux (GERD) and esophageal cancers.
Esophageal Obstruction: Can be functional or mechanical, impeding food delivery. Eosinophilic esophagitis is increasing; symptoms include dysphagia and food impaction.

Definition: Complication of chronic GERD marked by intestinal metaplasia in esophageal squamous mucosa, seen in approximately 10% of GERD patients.
Demographics: Most common in white males 40-60 years old; associated with increased risk of esophageal adenocarcinoma.
Pathology: Characterized by red, velvety mucosa with intestinal-type metaplasia and goblet cells; dysplasia may develop as condition progresses.
Diagnosis: Identified through endoscopy and biopsy, often initiated by GERD symptoms. May show amplification of oncogenes such as EGFR.
Cancer Risk: Most esophageal adenocarcinomas arise in this context; associated with significant mortality.

Location: Usually occurs in the distal third of the esophagus; can invade adjacent structures, leading to various complications.
Morphology: May present as exophytic masses or ulcerative lesions. Microscopic examination reveals invasive glands with malignant features.
Clinical Features: Symptoms include dysphagia, odynophagia, progressive weight loss, and hematemesis; advanced cases often diagnosed late with poor prognosis.
Prognosis: Less than 25% 5-year survival rate due to late diagnosis and advanced cancer stage.

Demographics: More common in individuals over 45, particularly in males and African Americans.
Risk Factors: Related to alcohol and tobacco use, poor diet, radiation exposure, and certain syndromes (e.g., Plummer-Vinson).
Pathogenesis: Characterized by genetic abnormalities, including SOX2 amplification and TP53 mutations.
Growth: Begins as squamous dysplasia and can develop into exophytic masses or narrow the esophageal lumen.
Complications: Invasion into surrounding structures can lead to severe conditions, such as respiratory illness or catastrophic bleeding.

Symptoms: Initially manifests as dysphagia, later with more severe features like hematemesis and weight loss.
Prognosis: 5-year survival rates vary by stage; 75% in superficial cases, but significantly lower for advanced disease with lymphatic spread.