Esophageal Cancer

Epidemiology. Carcinoma of the esophagus represents 1% of all cancers in the United States and causes 1.8% of cancer deaths. The two principal histologies are adenocarcinoma and squamous cell carcinoma. Risk factors for squamous cell esophageal cancer include African American race, alcohol and cigarette use, tylosis, achalasia, caustic esophageal injury, […]

Barrett Esophagus

Barrett Esophagus is defined as a metaplastic transformation of esophageal mucosa resulting from chronic GER. Histologically, the metaplastic epithelium must demonstrate intestinal-type metaplasia characterized by the presence of goblet cells. The columnar epithelium of Barrett esophagus may replace the normal squamous epithelium circumferentially, or it may be asymmetric and irregular

Benign Esophageal Neoplasms

Benign Esophageal Neoplasms are rare, although probably many remain undetected. The most common lesions are mesenchymal tumors such as gastrointestinal stromal tumors and leiomyomas, followed by polyps. Less common lesions include hemangioma and granular cell myoblastoma. A. Clinical features Clinical features depend primarily on the location of the tumor within […]

Caustic Ingestion

Liquid alkali solutions (e.g., Drano and Liquid-Plumr) are responsible for most of the serious caustic esophageal and gastric injuries, producing coagulation necrosis in both organs. Acid ingestion is more likely to cause isolated gastric injury.

Esophageal Perforation

Overall, perforation is associated with a 20% mortality rate. The etiologies may be broadly divided into intra- and extraluminal categories. Intraluminal causes Instrumentation injuries represent 75% of esophageal perforations and may occur during endoscopy, dilation, sclerosis of esophageal varices, transesophageal echocardiography, and tube passage. The most common sites are the […]

Esophageal Diverticula

Esophageal Diverticula are acquired conditions of the esophagus found primarily in adults. They are divided into traction and pulsion diverticula based on the pathophysiology that induced their formation.

Esophageal Strictures

Esophageal Strictures are either benign or malignant, and the distinction is critical. Benign strictures are either congenital or acquired.

Functional Esophageal Disorders

Functional Esophageal Disorders comprise a diverse group of disorders involving esophageal skeletal or smooth muscle. A. Motor disorders of esophageal skeletal muscle Motor disorders of esophageal skeletal muscle result in defective swallowing and aspiration. Potential causes can be classified into five major subgroups: neurogenic, myogenic, structural, iatrogenic, and mechanical. Most […]

Gastroesophageal Reflux

Pathophysiology in GER relates to abnormal exposure of the distal esophagus to refluxed stomach contents. In 60% of patients, a mechanically defective lower-esophageal sphincter (LES) is responsible for the GER. The sphincter function of the LES depends on the integrated mechanical effect of the sphincter’s intramural pressure and the length of esophagus exposed to intra-abdominal positive pressure. Other etiologies of GER are inefficient esophageal clearance of refluxed material, fixed gastric outlet obstruction, functional delayed gastric emptying, increased gastric acid secretion, and inappropriate relaxation of the LES.