Postprandial emesis suggests lower esophageal disease.
Pain, Emesis, Weight Loss - Think
Can look for palpable masses/lymph nodes Succussion Splash- Sloshing sound heard on auscultation of stomach when pt. is rocked back and forth at the hips- often suggests gastric outlet obstruction or gastroparesis. One small study found ~1/3 of pts. with GOO to have + succussion splash.
Posted 01/04/17 11:09:39 AM by Adam Faye
UGI Series: Drink barium contrast and multiple radiographs taken to see how contrast moves through esophagus and stomach Endoscopy
Carcinomas - Difficult to pass endoscope across Achalasia - Easy to push through with endoscope
Posted 01/04/17 11:14:18 AM by Adam Faye
Posted 01/04/17 11:21:24 AM by Adam Faye
Esophageal Carcinoma: Two main subtypes of esophageal carcinoma
Squamous Cell Carcinoma (precursor: squamous dysplasia) 90% of cases world-wide Predominant type in Asia, South America, Africa Risk factors: Tobacco, Alcohol Location: Proximal – middle esophagus Adenocarcinoma (precursor: Barrett’s esophagus)
Increasing prevalence in North America, Europe Risk factors: GERD, obesity, tobacco Location: Distal esophagus
Posted 01/04/17 11:23:17 AM by Adam Faye
Esophageal SCC Treatment: Standard is concurrent radiation + chemotherapy
No standard regimen (typically FU + cisplatin v paclitaxel + carboplatin)
Radiation v stents for dysphagia
Posted 01/04/17 11:25:25 AM by Adam Faye
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