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CAUSTIC INJURY Caustic injury to the oesophagus can be mild, but also is - potentially lethal. Most caustic ingestions occur in children, in whom it is usually accidental, or in adults with suicidal intent. The severity of the injury depends on the type, pH, ...

Clinical features Symptoms of GORD can be classified into oesophageal or extraoesophageal. Typical oesophageal complaints include heartburn, which is defined as a burning sensation behind the sternum, and regurgitation, which is the perception of the flow of r...

Complex gastro-oesophageal reflux disease Peptic strictures and dilatation Reflux-induced strictures are relatively rare in the era of PPIs as most patients will be treated empirically before long-term complications occur. These strictures generally respond wel...

Diagnosis In most cases, the diagnosis is assumed rather than proven, and treatment is empirical. Proton pump inhibitors (PPIs) are very e ff ective drugs in managing erosive oesophagitis and acid-related symptoms. They are often used empirically as a diagnosti...

Disease staging Careful disease staging is essential to guide therapy . Current staging classification according to the American Joint Commit tee on Cancer (AJCC)/Union for International Cancer Control (UICC) (8th edition) is shown in Table 66.4 . The T stage a...

EOSINOPHILIC OESOPHAGITIS EOO is defined as a chronic, immune/antigen-mediated oesophageal disease, characterised clinically by symptoms related to oesophageal dysfunction and histologically by - eosinophil-predominant inflammation. However, there is over - lap...

Endoluminal functional lumen imaging planimetry Endoluminal functional lumen imaging planimetry (FLIP) is a volume-controlled distension balloon device. It utilises imped - ance planimetry to measure the cross-sectional areas along the length of the balloon, ...

Endoscopy Endoscopy is an essential tool with both diagnostic and thera - peutic roles. A standard diagnostic upper endoscopy includes the examination of the pharynx, hypopharynx, laryngeal inlet, - oesophagus, stomach and part of the duodenum. The risk of t...

Endosonography Endoscopic ultrasonography (EUS) relies on a high-frequency (5–30 /uni00A0 MHz) transducer to provide highly detailed images of the layers of the oesophageal wall and mediastinal structures close to the oesophagus. There are two types of EUS: r...

FOREIGN BODIES IN OESOPHAGUS Swallowed foreign bodies are common and tend to impact at the three narrow portions of the oesophagus; namely , the cricopharyngeus/pyriform fossa, the midoesophagus where the aorta/left main bronchus crosses the oesophagus and at ...

FURTHER READING Bennett RD, Starghan DM, V elanocivh V . Gastroesophageal reflux dis - ease, hiatal hernia, and Barrett esophagus. In: Zinner MJ, Ashley SW , Hines OJ (eds). Maingot’s abdominal operations , 13th edn. New Y ork: McGraw-Hill, 2019: 393–422. Hölsc...

GASTRO-OESOPHAGEAL REFLUX DISEASE Aetiology GORD is defined by the ‘Montreal definition’ as a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. The aetiology of GORD can be explained by the interaction...

INVESTIGATIONS OF

Introduction No content extracted automatically.

Learning objectives To understand: The anatomy and physiology of the oesophagus and their benign and malignant disease with particular reference to • relationship to disease common adult disorders

MALLORY–WEISS SYNDROME AND INTRAMURAL OESOPHAGEAL HAEMATOMA/DISSECTION Forceful vomiting may lead to a tear at the OGJ, mostly imme diately below the squamocolumnar junction. Patients present with haematemesis. Bleeding is rarely severe, and the diagnosis Geor...

MISCELLANEOUS CONDITIONS Plummer–Vinson (in the USA) or Paterson–Brown-Kelly syndrome (UK) refers to the findings of a cervical oesophageal web, iron deficiency anaemia and dysphagia. It is also known as sideropenic dysphagia. The pathophysiology remains elusiv...

MOTILITY DISORDERS AND DIVERTICULA Oesophageal motility disorders Oesophageal motility disorders are a spectrum of diseases that involve the diminished, overaction or desynchronised neuro muscular function of the oesophageal body or sphincters. The most comm...