Lec 3 esophagus .pdf

Internal Medicine Based on Kirkuk University Lectures Presented By Dr. Mohammed Alaa By Next Lecture esophagitis Barret- premalignant >  gullet Other causes of oesophagitis 1.Infection,candidiasis, immune...

Internal Medicine Based on Kirkuk University Lectures Presented By Dr. Mohammed Alaa By Next Lecture esophagitis Barret- premalignant >  gullet Other causes of oesophagitis 1.Infection,candidiasis, immune - - & compromised pt. broad - ACCIDANTAL spectrum antibiotic, cytotoxic SUCCIDE drugs - - 2.Corrosives ,bleach , battery & acid : painful pain & burn of - & - & mouth , erosive esophgitis - - & - F - - perforation,mediasinitis,strictur &media num infla -  & - & - - - - => - - - Misso & By's & - - * => - - - & = dia > - prima - I des Helier Bisphosphonates are a group of stend medicines used to treat osteopenia or osteoporosis - d during repair ↑ - & & "ejj, - - - & 1444 - density of ba & - => - - -  Great role in ↑ in mucosa of autoimmun allergy & - - Eosinophlic esophgeatis so > - in abopic patient ⑪ ↓ high digre Sij" - Sus in ebsenstivity - ↑ = muydj - nAtopic persons > - JebO en n Eosinophlic infiltration of mucosa - Dat n Dysphagia n Esophageal ring - O & & n Ppi & - & - n Steroid inhaler ? => 4 & & J 3 - - - S &n - 1 -  died- PDI-topical > > - oral steroid tab. Smoksteroid a liquid meal replacement diet that - offers - a complete nutritional profile - & broken - down into its most “elemental” - form. - - & - - elimination diet, a food or group & - of foods is removed from a& - - - => persons diet for a set period of => - time. This helps to determine * - - whether specific foods or - - - ingredients in foods contribute to - * - - symptoms - - & - & - - - - - n - &19 - - => - & - => - - - steroid - - - - - - - - - - - - - - => > - ESOPHGEAL PATHOLOGY cosinophic esophagibis * & - - & (1) spindle Flask sigmoid type = V Motility disorder narrowing -1 - Ej Achalasia Hypertonic LOS, failure to relax in response to - - & swallowing wave. - Cause Defect release of& - NO.by inhibitory neuron in - LOS - Degeneration of gangloinic cells within - - sphincter & body of esophgus & & - = 55149  - - - - - > - - Tiang NO - - - - - - - · ure - - - - & & -- - = +s - - * - = - - & & & 1st alses & & - - -, / - & - - egical chest pain i i · , spasm - - - - - -  Clinical feature Dysphgia slowly progressive, - intermittent, start with solid, dec. with - - - liquid drinking, standing , moving > - -- around. - G - Y - Chest pain 25s & ·: 9 -jes sacid % 10 Heart burn ??? & 818). - so & Jig Nocturnal pulmonary aspiration & - Squamous ca veinomm - consoldation - Investigation opacity # · o CXR , widening Mediastinum, aspiration pneumonia - city => o Barium swallow o&OGD + Bx ? Biopsy pusdoachlasia o Manometery to& confirms the - diagnosis 861125 - & oesophago-gastroduodenoscopy I  Cardium & damage be ⑤ > - sphincter - lead - - ke GERD - End - - & - & labroscope = - - & - - - - - - & - - - - & - - - Fig 23-35 - - labroscopes Heler's - - - - - - GERD - - Fundiplic  preumatic Ballon Dilatation Treatment v & & Endoscopic pneumatic dilation v Botulinum toxin injection in LOS - v Surgical myotomy *Huller s operation e => v Antireflux procedure ?? - Partial fandiplication 61 miss , fundplication  Distal Diffuse esophageal spasm - forceful peristaltic activity n - Late middle age n Episodic of chest pain mimic angina - - - spasm/las n Transient dysphgea - & - > - n Ppi m - - = - GERD - & - n Nitrate, nfidipin - & - - - + > - n Pneumatic dilatation, myotomy & & & 46 ↳ &= & , 1)21]  Barium rub Causes of esophageal stricture & CircumfrenceI layers n GERD - - Web or ring & & - n & - & & n Ca esophagus - - - - dim - & - pharynx Smoth & - -%5 & Eosiophlic esophgetis. - - n - - - - - - n Extrinsic & compression - - - - - n Corrosive ingestion n Post operative scaring Post radiotherapy & n & n - & Long term NG tube bl - - - , n - biphosphonate - - - - Ring L - & I - - 6 -  psude ?? achalasia Bead eat Dat Karl  ?? Smoth a Care Stricture Out growth Carcinom  ????? corrosive & - - - & - - z - - - - - - #S - - - stricture -= Plummer-Vinson syndrome is defined by the classic triad of - dysphagia, iron-deficiency anemia and esophageal webs. - & Even though the syndrome is very rare nowadays, its web - recognition is important because it identifies a group of patients at increased risk of squamous cell carcinoma of the - pharynx and the esophagus. - = - Sidropenid dysphan & --- Gat & Kollomychia - 79 ·  ?? well  rare s 34/ ??? - - - - 9) - > - -ifidipin nitrate sever peristaltic wave spasm NEXT LECTURE Onwards and Upwards CONTACT US @nextlecturesupport [email protected] www.nextlecture.org