The document provides information on the anatomy, physiology, and pathologies of the esophagus. It discusses the layers of the esophagus, blood supply, nerve supply, and functions like peristalsis. Key pathologies covered include dysphagia, achalasia, gastroesophageal reflux, and esophageal cancer. Esophageal cancer is further discussed in terms of risk factors, staging, and surgical management options like Ivor Lewis esophagectomy.
Explanation of what splenomegaly is in relation to its dimension deviation from normal spleen.Classification of splenomegaly according to it's size in adult and pediatric. The causes of splenomegaly along with the symptom that would manifest as a result of this anomaly. Lastly, diagnosis of splenomegaly
Carcinoma esophagus is the common cause for dysphagia for solids. These patients usually present too late to do any definitive curative surgical procedure.
Anatomy, physiology and diagnosis of oesophageal diseasesAnwaaar
This document discusses the anatomy, physiology, and diagnosis of oesophageal diseases. It covers the surgical anatomy of the oesophagus, its physiology during swallowing, common symptoms of oesophageal diseases, and investigations used in diagnosis including barium swallow, endoscopy, endosonography, manometry, and pH monitoring. It also discusses specific oesophageal diseases and conditions such as congenital lesions, benign tumors, cancer, foreign bodies, perforations, gastroesophageal reflux disease, hiatal hernia, and motility disorders.
This document discusses various topics related to diseases of the esophagus including:
1. Causes, symptoms, diagnosis and treatment of esophageal rupture and perforation.
2. Etiology, clinical features, diagnosis and management of corrosive esophageal burns.
3. Etiology, clinical features, diagnosis and endoscopic treatment of esophageal strictures.
4. Causes, symptoms, diagnosis and treatment options for gastroesophageal reflux disease and Barrett's esophagus.
This document summarizes the anatomy, histology, common abnormalities and disorders of the esophagus. It discusses congenital anomalies like tracheoesophageal fistulas. It also covers acquired conditions such as esophageal diverticula, motor disorders like achalasia, inflammatory disorders including different types of esophagitis, Barrett's esophagus and esophageal cancer. Esophageal adenocarcinoma arises from Barrett's esophagus while squamous cell carcinoma is more common in other parts of the esophagus. Both types usually present at late stages with poor prognosis.
The document provides information about appendicitis, including its definition, pathophysiology, clinical features, diagnosis, differential diagnosis, and treatment. It states that appendicitis is caused by obstruction of the appendix lumen, most commonly by a faecalith. It describes the progression from obstruction to infection and perforation. It outlines the typical symptoms of abdominal pain that migrates to the right lower quadrant, anorexia, vomiting, and low-grade fever. It provides details on various clinical examination signs used in diagnosis like rebound tenderness and McBurney's point tenderness.
This document discusses various motility disorders and conditions that affect the esophagus. It begins by describing different types of motility disorders like achalasia and diverticula. It then focuses on achalasia, describing its pathogenesis, clinical presentation, diagnostic tests like esophagram and manometry, and various treatment methods. The document also discusses other topics like esophageal diverticula, benign and malignant neoplasms, perforations, injuries, and acid reflux conditions like Barrett's esophagus. Esophageal manometry is described as the most accurate way to assess motility disorders, and high-resolution manometry is mentioned as an improved technique.
This document provides an outline and overview of patterns for recognizing abnormalities on abdominal CT scans. It discusses various patterns for strictures, polyps, bowel wall thickening, enhancement patterns, length of bowel involvement, mesenteric abnormalities, lumen contents, pneumoperitoneum, and differentiating benign from malignant findings. Key points include differentiating short from long strictures, characteristics of various polyps, the water target sign and other enhancement patterns, findings suggestive of ischemia, and recognizable signs of pneumoperitoneum. The document is intended as an educational guide for interpreting abdominal CT scans.
Explanation of what splenomegaly is in relation to its dimension deviation from normal spleen.Classification of splenomegaly according to it's size in adult and pediatric. The causes of splenomegaly along with the symptom that would manifest as a result of this anomaly. Lastly, diagnosis of splenomegaly
Carcinoma esophagus is the common cause for dysphagia for solids. These patients usually present too late to do any definitive curative surgical procedure.
Anatomy, physiology and diagnosis of oesophageal diseasesAnwaaar
This document discusses the anatomy, physiology, and diagnosis of oesophageal diseases. It covers the surgical anatomy of the oesophagus, its physiology during swallowing, common symptoms of oesophageal diseases, and investigations used in diagnosis including barium swallow, endoscopy, endosonography, manometry, and pH monitoring. It also discusses specific oesophageal diseases and conditions such as congenital lesions, benign tumors, cancer, foreign bodies, perforations, gastroesophageal reflux disease, hiatal hernia, and motility disorders.
This document discusses various topics related to diseases of the esophagus including:
1. Causes, symptoms, diagnosis and treatment of esophageal rupture and perforation.
2. Etiology, clinical features, diagnosis and management of corrosive esophageal burns.
3. Etiology, clinical features, diagnosis and endoscopic treatment of esophageal strictures.
4. Causes, symptoms, diagnosis and treatment options for gastroesophageal reflux disease and Barrett's esophagus.
This document summarizes the anatomy, histology, common abnormalities and disorders of the esophagus. It discusses congenital anomalies like tracheoesophageal fistulas. It also covers acquired conditions such as esophageal diverticula, motor disorders like achalasia, inflammatory disorders including different types of esophagitis, Barrett's esophagus and esophageal cancer. Esophageal adenocarcinoma arises from Barrett's esophagus while squamous cell carcinoma is more common in other parts of the esophagus. Both types usually present at late stages with poor prognosis.
The document provides information about appendicitis, including its definition, pathophysiology, clinical features, diagnosis, differential diagnosis, and treatment. It states that appendicitis is caused by obstruction of the appendix lumen, most commonly by a faecalith. It describes the progression from obstruction to infection and perforation. It outlines the typical symptoms of abdominal pain that migrates to the right lower quadrant, anorexia, vomiting, and low-grade fever. It provides details on various clinical examination signs used in diagnosis like rebound tenderness and McBurney's point tenderness.
This document discusses various motility disorders and conditions that affect the esophagus. It begins by describing different types of motility disorders like achalasia and diverticula. It then focuses on achalasia, describing its pathogenesis, clinical presentation, diagnostic tests like esophagram and manometry, and various treatment methods. The document also discusses other topics like esophageal diverticula, benign and malignant neoplasms, perforations, injuries, and acid reflux conditions like Barrett's esophagus. Esophageal manometry is described as the most accurate way to assess motility disorders, and high-resolution manometry is mentioned as an improved technique.
This document provides an outline and overview of patterns for recognizing abnormalities on abdominal CT scans. It discusses various patterns for strictures, polyps, bowel wall thickening, enhancement patterns, length of bowel involvement, mesenteric abnormalities, lumen contents, pneumoperitoneum, and differentiating benign from malignant findings. Key points include differentiating short from long strictures, characteristics of various polyps, the water target sign and other enhancement patterns, findings suggestive of ischemia, and recognizable signs of pneumoperitoneum. The document is intended as an educational guide for interpreting abdominal CT scans.
The document discusses the anatomy and pathologies of the esophagus. It describes the layers of the esophagus and contains sphincters. Lesions can cause dysphagia due to narrowing or obstruction. Gastroesophageal reflux disease is a common cause of heartburn. Varices are dilated veins caused by portal hypertension. Achalasia is a motility disorder causing difficulty swallowing. Barrett's esophagus is a complication of long-term reflux and increases cancer risk. Squamous cell carcinoma and adenocarcinoma are the two main types of esophageal cancer.
Abdominal tuberculosis is common in India and other developing countries. It can affect the intestines, peritoneum, mesentery and lymph nodes. Symptoms include abdominal pain, diarrhea, weight loss and fever. Diagnosis involves imaging tests like ultrasound and CT scan as well as biopsy of affected tissues. Treatment consists of a combination of anti-tuberculosis drugs for at least 6-12 months as well as possible surgery for complications like obstruction or abscess. Regular follow up is needed to monitor response to treatment.
The document discusses various disorders that can affect the esophagus, including perforations, burns, benign strictures, hiatal hernias, and motility disorders. It also covers gastroesophageal reflux disease and its complications. Finally, it examines both benign and malignant neoplasms of the esophagus, outlining the histological progression and treatment options for esophageal cancer.
This document summarizes various benign lesions of the stomach and duodenum. It describes the gross anatomy and embryology of the stomach and duodenum. It then discusses several specific benign conditions like idiopathic hypertrophic pyloric stenosis, duodenal atresia, gastric and duodenal diverticula, gastric and duodenal webs, gastric ulcers, and various inflammatory conditions of the stomach and duodenum including erosive gastritis, antral gastritis, helicobacter pylori gastritis, hypertrophic gastritis, and Menetrier's disease. It provides details on clinical features, investigative findings, treatment and prognosis for many of these conditions.
This document discusses esophageal motility disorders. It begins with the anatomy of the esophagus, including its three parts (cervical, thoracic, abdominal) and normal narrowings. It then covers the physiology of peristalsis and swallowing. The main types of esophageal motility disorders are described - achalasia (failure of LES to relax), spastic disorders like DES and nutcracker esophagus, and presbyoesophagus in elderly patients. Diagnostic tests like manometry and scintigraphy transit tests are also summarized.
This document discusses benign disorders of the esophagus, focusing on GERD (gastroesophageal reflux disease). It covers the epidemiology, pathophysiology, symptoms, diagnostic tests and treatment options for GERD. Regarding treatment, lifestyle modifications and medications like antacids, H2 blockers, and proton pump inhibitors are discussed as first-line options. Endoscopic treatments and anti-reflux surgery are also mentioned.
Dd’s of esophageal stricture and intra luminal filling defectsairwave12
The esophagus is approximately 25cm long, running from the C6 to T11 vertebrae. It has three areas of narrowing and passes through the thorax, where it is divided into four segments for staging of diseases. Esophageal strictures are narrowings that can cause swallowing difficulties and are often caused by gastroesophageal reflux disease, injuries from medical procedures, or ingestion of corrosives. Symptoms include dysphagia and weight loss, and strictures are evaluated using barium swallows, endoscopy, and biopsy. Complications arise from malnutrition, aspiration, and infections.
RIGHT ILIAC FOSSA LUMP, WITH SPECIAL REFERENCE TO RIGHT COLONIC CANCERArkaprovo Roy
This document discusses potential causes of masses in the right iliac fossa, including appendicular abscess, appendicular mass, ileocecal tuberculosis, and carcinoma of the caecum. It provides characteristics of some common right iliac fossa masses like appendicular masses being tender, soft to firm, and having ill-defined borders, while ileocecal tuberculosis masses are firm to hard and highly placed. The document also reviews colon carcinoma risks such as aging, hereditary factors, and diet high in animal fat or low in fiber, as well as the pathogenesis involving mutations in microsatellite sequences regulating cell growth.
The document discusses appendicitis, including:
- The blood and lymph drainage of the appendix, supplied by the appendicular artery.
- The symptoms of appendicitis include colicky abdominal pain shifting to the right lower quadrant, fever, nausea and vomiting.
- The diagnosis is clinical, using tests like the Alvarado score, and may include ultrasound or CT scans.
- Treatment is usually an appendectomy, which can be open or laparoscopic. Complications include wound infections, intra-abdominal abscesses, and adhesive bowel obstructions. Rarely, appendicitis can be treated non-operatively with antibiotics.
This document provides guidelines for managing patients with acute lower gastrointestinal bleeding (LGIB). It recommends initially assessing the patient's hemodynamic status and performing resuscitation if needed. Risk stratification should then be done to determine if the patient is at high or low risk of adverse outcomes. For most patients, colonoscopy should be the initial diagnostic procedure and should be performed within 24 hours of presentation after adequate bowel preparation. Endoscopic hemostasis therapy is recommended for patients found to have active bleeding, non-bleeding visible vessels, or adherent clots during colonoscopy. Non-colonoscopic interventions like radiographic tests or surgery may be considered for high-risk patients who cannot undergo colonoscopy.
The document provides an overview of the anatomy, embryology, imaging, and physiology of the esophagus. It discusses the esophagus' layers, blood supply, lymphatic drainage and innervation. Imaging modalities like barium swallow, endoscopic ultrasound, CT and MRI are described. Barium swallow is useful for evaluating disorders while endoscopic ultrasound is best for T-staging cancer. CT is optimal for assessing extraesophageal disease and lymph nodes. The esophagus acts as a conduit between the pharynx and stomach during swallowing.
The document discusses esophagus cancer, including that cancer usually causes narrowing of the esophagus and trouble swallowing. It covers measuring the location of tumors, lymph nodes at risk, reading CT and PET scans to locate cancer, and the two main types of esophagus cancer - squamous cell carcinoma and adenocarcinoma. Side effects of treatment like radiation are also mentioned, such as sore throat, trouble swallowing, cough, and fatigue.
This document discusses pathology related to the esophagus, including motor dysfunctions like achalasia, gastroesophageal reflux disease (GERD), Barrett's esophagus, and tumors. It describes the anatomy of the esophagus and principal symptoms of esophageal disorders such as heartburn, dysphagia, and odynophagia. Causes, diagnosis, and features of esophagitis, GERD, Barrett's esophagus, esophageal varices, and esophageal cancers including squamous cell carcinoma and adenocarcinoma are summarized. Risk factors, pathogenesis, histological findings, and prognosis of these conditions are also outlined.
This document provides information about carcinoma of the esophagus, including its epidemiology, risk factors, pathological classification, clinical features, investigations, diagnosis and staging, and treatment. Carcinoma of the esophagus is most common in China, South Africa, and parts of India. It typically presents with dysphagia. Investigations include endoscopy with biopsy, imaging like CT and PET scans, and endoscopic ultrasound. Treatment depends on the stage, with surgery or chemoradiation used for early-stage or locally advanced carcinoma, and palliative approaches for metastatic disease.
This document discusses lower gastrointestinal bleeding, including definitions, classifications, differential diagnoses, investigations, and treatments. It covers conditions such as hemorrhoids, carcinoma of the rectum, diverticular disease, peri-anal hematoma, and fissure-in-ano. For each condition, it describes symptoms, signs on examination, investigations, differential diagnoses, complications, and treatment approaches.
This document discusses the anatomy, clinical presentation, diagnosis, and treatment of acute appendicitis. It notes that the appendix is considered a vestigial organ but can be important in surgery. Acute appendicitis is commonly caused by obstruction of the lumen. Clinical features include pain shifting to the lower right abdomen, anorexia, nausea, and fever. Diagnosis involves blood tests, urine analysis, and imaging like ultrasound or CT scan. Treatment is typically open or laparoscopic appendicectomy. Complications can include perforation, infection, or abscess. Conservative treatment with antibiotics may be used for appendicular masses.
Pyogenic and amebic liver abscesses can develop from a variety of causes. Ultrasound or CT imaging are used to identify abscesses, which appear as hypoechoic or low attenuation areas on scans. Treatment involves intravenous antibiotics along with drainage of larger abscesses via needle aspiration or catheter placement. For pyogenic abscesses, antibiotics are chosen based on culture results and typically include combinations targeting common bacteria. Amebic abscesses are generally treated with metronidazole or other nitroimidazole antibiotics, sometimes along with drainage or other antiparasitic drugs. Complications can arise if abscesses rupture or spread beyond the liver.
This document discusses various diseases and disorders of the esophagus. It begins by describing the embryologic development and anatomy of the esophagus. It then covers clinical topics like hiatal hernia, reflux esophagitis, esophageal motility disorders like achalasia, and esophageal neoplasms. Surgical conditions involving the esophagus like traumatic rupture or perforation are also reviewed. Treatment options for many of these esophageal diseases and disorders are provided.
1. The document discusses several abdominal radiology cases presented at a case conference, including a slipped lap band, C. difficile colitis, levamisole-induced vasculitis, inflammatory bowel diseases, and images in mixed inflammatory bowel disease.
2. Key findings are described from a CT scan showing pneumatosis intestinalis and mesenteric vein gas in a patient with abdominal distension and vomiting being evaluated for ileus.
3. Another case discusses findings from a CT consistent with acute sigmoid volvulus without evidence of bowel perforation or other complications. Emergent surgical consultation is recommended.
The document discusses the radiological approach to evaluating acute abdominal pain. It outlines various imaging techniques including plain X-rays, ultrasound, and CT scans. CT is superior for confirming diagnoses, detecting complications like free air or fluid collections. Common causes of abdominal pain by quadrant are described. Key findings on imaging for conditions like bowel obstruction, ileus, pancreatitis and cholecystitis are provided.
A Case Of Dysphagia- Stricture Esophagus.pptxAhsanJamil50
This patient experienced persistent vomiting and inability to swallow after accidentally ingesting sulfuric acid. He was diagnosed with an esophageal stricture and diverticulum via endoscopy. The stricture was initially dilated but he remained unable to eat solid foods. Further endoscopy revealed the diverticulum, and radiological studies showed spillage into the trachea and strictures in the stomach and duodenum from the acid exposure. The patient has been diagnosed with an esophageal stricture and diverticulum resulting from the ingestion of sulfuric acid.
Eamc endoscopic radiologic conference 2014Meanne Go
This document describes three patient cases:
1. A 34-year-old female presenting with fever, cough, and epigastric pain. Imaging showed abnormalities and further workup is needed to determine the diagnosis and treatment plan.
2. A 38-year-old male with a history of hepatobiliary TB presenting with jaundice and melena. Endoscopy and imaging suggest a hepatic artery aneurysm possibly related to prior TB infection.
3. A 47-year-old male presenting with epigastric pain, fever, anorexia, and melena. Endoscopy revealed a gastric ulcer penetrating into the liver, which was drained ultrasonographically. Further management of the liver abscess is required
The document discusses the anatomy and pathologies of the esophagus. It describes the layers of the esophagus and contains sphincters. Lesions can cause dysphagia due to narrowing or obstruction. Gastroesophageal reflux disease is a common cause of heartburn. Varices are dilated veins caused by portal hypertension. Achalasia is a motility disorder causing difficulty swallowing. Barrett's esophagus is a complication of long-term reflux and increases cancer risk. Squamous cell carcinoma and adenocarcinoma are the two main types of esophageal cancer.
Abdominal tuberculosis is common in India and other developing countries. It can affect the intestines, peritoneum, mesentery and lymph nodes. Symptoms include abdominal pain, diarrhea, weight loss and fever. Diagnosis involves imaging tests like ultrasound and CT scan as well as biopsy of affected tissues. Treatment consists of a combination of anti-tuberculosis drugs for at least 6-12 months as well as possible surgery for complications like obstruction or abscess. Regular follow up is needed to monitor response to treatment.
The document discusses various disorders that can affect the esophagus, including perforations, burns, benign strictures, hiatal hernias, and motility disorders. It also covers gastroesophageal reflux disease and its complications. Finally, it examines both benign and malignant neoplasms of the esophagus, outlining the histological progression and treatment options for esophageal cancer.
This document summarizes various benign lesions of the stomach and duodenum. It describes the gross anatomy and embryology of the stomach and duodenum. It then discusses several specific benign conditions like idiopathic hypertrophic pyloric stenosis, duodenal atresia, gastric and duodenal diverticula, gastric and duodenal webs, gastric ulcers, and various inflammatory conditions of the stomach and duodenum including erosive gastritis, antral gastritis, helicobacter pylori gastritis, hypertrophic gastritis, and Menetrier's disease. It provides details on clinical features, investigative findings, treatment and prognosis for many of these conditions.
This document discusses esophageal motility disorders. It begins with the anatomy of the esophagus, including its three parts (cervical, thoracic, abdominal) and normal narrowings. It then covers the physiology of peristalsis and swallowing. The main types of esophageal motility disorders are described - achalasia (failure of LES to relax), spastic disorders like DES and nutcracker esophagus, and presbyoesophagus in elderly patients. Diagnostic tests like manometry and scintigraphy transit tests are also summarized.
This document discusses benign disorders of the esophagus, focusing on GERD (gastroesophageal reflux disease). It covers the epidemiology, pathophysiology, symptoms, diagnostic tests and treatment options for GERD. Regarding treatment, lifestyle modifications and medications like antacids, H2 blockers, and proton pump inhibitors are discussed as first-line options. Endoscopic treatments and anti-reflux surgery are also mentioned.
Dd’s of esophageal stricture and intra luminal filling defectsairwave12
The esophagus is approximately 25cm long, running from the C6 to T11 vertebrae. It has three areas of narrowing and passes through the thorax, where it is divided into four segments for staging of diseases. Esophageal strictures are narrowings that can cause swallowing difficulties and are often caused by gastroesophageal reflux disease, injuries from medical procedures, or ingestion of corrosives. Symptoms include dysphagia and weight loss, and strictures are evaluated using barium swallows, endoscopy, and biopsy. Complications arise from malnutrition, aspiration, and infections.
RIGHT ILIAC FOSSA LUMP, WITH SPECIAL REFERENCE TO RIGHT COLONIC CANCERArkaprovo Roy
This document discusses potential causes of masses in the right iliac fossa, including appendicular abscess, appendicular mass, ileocecal tuberculosis, and carcinoma of the caecum. It provides characteristics of some common right iliac fossa masses like appendicular masses being tender, soft to firm, and having ill-defined borders, while ileocecal tuberculosis masses are firm to hard and highly placed. The document also reviews colon carcinoma risks such as aging, hereditary factors, and diet high in animal fat or low in fiber, as well as the pathogenesis involving mutations in microsatellite sequences regulating cell growth.
The document discusses appendicitis, including:
- The blood and lymph drainage of the appendix, supplied by the appendicular artery.
- The symptoms of appendicitis include colicky abdominal pain shifting to the right lower quadrant, fever, nausea and vomiting.
- The diagnosis is clinical, using tests like the Alvarado score, and may include ultrasound or CT scans.
- Treatment is usually an appendectomy, which can be open or laparoscopic. Complications include wound infections, intra-abdominal abscesses, and adhesive bowel obstructions. Rarely, appendicitis can be treated non-operatively with antibiotics.
This document provides guidelines for managing patients with acute lower gastrointestinal bleeding (LGIB). It recommends initially assessing the patient's hemodynamic status and performing resuscitation if needed. Risk stratification should then be done to determine if the patient is at high or low risk of adverse outcomes. For most patients, colonoscopy should be the initial diagnostic procedure and should be performed within 24 hours of presentation after adequate bowel preparation. Endoscopic hemostasis therapy is recommended for patients found to have active bleeding, non-bleeding visible vessels, or adherent clots during colonoscopy. Non-colonoscopic interventions like radiographic tests or surgery may be considered for high-risk patients who cannot undergo colonoscopy.
The document provides an overview of the anatomy, embryology, imaging, and physiology of the esophagus. It discusses the esophagus' layers, blood supply, lymphatic drainage and innervation. Imaging modalities like barium swallow, endoscopic ultrasound, CT and MRI are described. Barium swallow is useful for evaluating disorders while endoscopic ultrasound is best for T-staging cancer. CT is optimal for assessing extraesophageal disease and lymph nodes. The esophagus acts as a conduit between the pharynx and stomach during swallowing.
The document discusses esophagus cancer, including that cancer usually causes narrowing of the esophagus and trouble swallowing. It covers measuring the location of tumors, lymph nodes at risk, reading CT and PET scans to locate cancer, and the two main types of esophagus cancer - squamous cell carcinoma and adenocarcinoma. Side effects of treatment like radiation are also mentioned, such as sore throat, trouble swallowing, cough, and fatigue.
This document discusses pathology related to the esophagus, including motor dysfunctions like achalasia, gastroesophageal reflux disease (GERD), Barrett's esophagus, and tumors. It describes the anatomy of the esophagus and principal symptoms of esophageal disorders such as heartburn, dysphagia, and odynophagia. Causes, diagnosis, and features of esophagitis, GERD, Barrett's esophagus, esophageal varices, and esophageal cancers including squamous cell carcinoma and adenocarcinoma are summarized. Risk factors, pathogenesis, histological findings, and prognosis of these conditions are also outlined.
This document provides information about carcinoma of the esophagus, including its epidemiology, risk factors, pathological classification, clinical features, investigations, diagnosis and staging, and treatment. Carcinoma of the esophagus is most common in China, South Africa, and parts of India. It typically presents with dysphagia. Investigations include endoscopy with biopsy, imaging like CT and PET scans, and endoscopic ultrasound. Treatment depends on the stage, with surgery or chemoradiation used for early-stage or locally advanced carcinoma, and palliative approaches for metastatic disease.
This document discusses lower gastrointestinal bleeding, including definitions, classifications, differential diagnoses, investigations, and treatments. It covers conditions such as hemorrhoids, carcinoma of the rectum, diverticular disease, peri-anal hematoma, and fissure-in-ano. For each condition, it describes symptoms, signs on examination, investigations, differential diagnoses, complications, and treatment approaches.
This document discusses the anatomy, clinical presentation, diagnosis, and treatment of acute appendicitis. It notes that the appendix is considered a vestigial organ but can be important in surgery. Acute appendicitis is commonly caused by obstruction of the lumen. Clinical features include pain shifting to the lower right abdomen, anorexia, nausea, and fever. Diagnosis involves blood tests, urine analysis, and imaging like ultrasound or CT scan. Treatment is typically open or laparoscopic appendicectomy. Complications can include perforation, infection, or abscess. Conservative treatment with antibiotics may be used for appendicular masses.
Pyogenic and amebic liver abscesses can develop from a variety of causes. Ultrasound or CT imaging are used to identify abscesses, which appear as hypoechoic or low attenuation areas on scans. Treatment involves intravenous antibiotics along with drainage of larger abscesses via needle aspiration or catheter placement. For pyogenic abscesses, antibiotics are chosen based on culture results and typically include combinations targeting common bacteria. Amebic abscesses are generally treated with metronidazole or other nitroimidazole antibiotics, sometimes along with drainage or other antiparasitic drugs. Complications can arise if abscesses rupture or spread beyond the liver.
This document discusses various diseases and disorders of the esophagus. It begins by describing the embryologic development and anatomy of the esophagus. It then covers clinical topics like hiatal hernia, reflux esophagitis, esophageal motility disorders like achalasia, and esophageal neoplasms. Surgical conditions involving the esophagus like traumatic rupture or perforation are also reviewed. Treatment options for many of these esophageal diseases and disorders are provided.
1. The document discusses several abdominal radiology cases presented at a case conference, including a slipped lap band, C. difficile colitis, levamisole-induced vasculitis, inflammatory bowel diseases, and images in mixed inflammatory bowel disease.
2. Key findings are described from a CT scan showing pneumatosis intestinalis and mesenteric vein gas in a patient with abdominal distension and vomiting being evaluated for ileus.
3. Another case discusses findings from a CT consistent with acute sigmoid volvulus without evidence of bowel perforation or other complications. Emergent surgical consultation is recommended.
The document discusses the radiological approach to evaluating acute abdominal pain. It outlines various imaging techniques including plain X-rays, ultrasound, and CT scans. CT is superior for confirming diagnoses, detecting complications like free air or fluid collections. Common causes of abdominal pain by quadrant are described. Key findings on imaging for conditions like bowel obstruction, ileus, pancreatitis and cholecystitis are provided.
A Case Of Dysphagia- Stricture Esophagus.pptxAhsanJamil50
This patient experienced persistent vomiting and inability to swallow after accidentally ingesting sulfuric acid. He was diagnosed with an esophageal stricture and diverticulum via endoscopy. The stricture was initially dilated but he remained unable to eat solid foods. Further endoscopy revealed the diverticulum, and radiological studies showed spillage into the trachea and strictures in the stomach and duodenum from the acid exposure. The patient has been diagnosed with an esophageal stricture and diverticulum resulting from the ingestion of sulfuric acid.
Eamc endoscopic radiologic conference 2014Meanne Go
This document describes three patient cases:
1. A 34-year-old female presenting with fever, cough, and epigastric pain. Imaging showed abnormalities and further workup is needed to determine the diagnosis and treatment plan.
2. A 38-year-old male with a history of hepatobiliary TB presenting with jaundice and melena. Endoscopy and imaging suggest a hepatic artery aneurysm possibly related to prior TB infection.
3. A 47-year-old male presenting with epigastric pain, fever, anorexia, and melena. Endoscopy revealed a gastric ulcer penetrating into the liver, which was drained ultrasonographically. Further management of the liver abscess is required
The document discusses the anatomy and physiology of the esophagus. It describes the esophagus as a muscular tube that extends from the pharynx to the stomach. It has three portions - cervical, thoracic, and abdominal. The document outlines the relations of the esophagus in each portion and describes conditions like dysphagia, esophageal sphincters, gastroesophageal reflux disease, achalasia, Zenker's diverticulum and their clinical features and treatments.
Pancreatitis -a detailed study ( medical information )martinshaji
Pancreatitis is the Inflammation of the pancreatic parenchyma. Acute condition of diffuse pancreatic inflammation & auto digestion, presents with abdominal pain, and is usually associated with raised pancreatic enzyme levels in the blood &urine. this is a detailed study pancreatitis describing factors such as definition , epidemiology , etiology , pathophysiology , treatment , prevention , imaging techniques , diagnosis , lab investigations , images , drugs , control etc
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This document discusses dysphagia (difficulty swallowing) by summarizing its anatomy, causes, evaluation, and treatments. Dysphagia can arise from problems in the oral, pharyngeal, or esophageal phases of swallowing and is evaluated through history, examination, imaging like barium swallow, and endoscopy. Common causes include oral cancers, pharyngeal infections or lesions, esophageal cancers, strictures, and motility disorders. Esophageal cancer is typically diagnosed by endoscopy and imaging and treated with surgery, radiation, chemotherapy, or a combination depending on stage. Outcomes remain poor with only 5-10% five-year survival for advanced esophageal cancer.
USMLE 01 Spleen anatomy medical spleen anatomy .pdfAHMED ASHOUR
The spleen is a vital organ in the human body that plays various roles in immune function, blood filtration, and storage of blood components. In some cases, a splenectomy (surgical removal of the spleen) may be necessary due to trauma, disease, or certain blood disorders. However, living without a spleen can increase the risk of certain infections, particularly those caused by encapsulated bacteria.
The spleen's multifaceted functions make it a crucial component of the immune and circulatory systems, contributing to overall health and homeostasis in the body.
In these slides we will go through the surgical anatomy of the gut,pathophysiology of intestinal obstruction, clinical presentation and management. Also we will discuss specific types of intestinal obstruction.
This document provides an overview of radiology findings for various gastrointestinal (GIT) and other body systems. For the GIT system, it describes normal anatomy and films of the esophagus, stomach, and duodenum. It then lists and explains common abnormalities seen on radiology studies for each area, including peptic ulcers, cancers, strictures, hernias, and other conditions. It also covers radiology of the renal, musculoskeletal, chest, and women's imaging systems, listing common indications, normal findings, and disease appearances.
The oesophagus is a 25cm tube connecting the pharynx to the stomach. It has three normal constrictions and consists of four layers. The main muscle layer contains striated muscle in the upper third and smooth muscle in the lower third. Achalasia cardia is failure of the lower oesophageal sphincter to relax during swallowing. Carcinoma of the oesophagus is often caused by smoking and alcohol and spreads locally and via lymph nodes or blood. Barium swallow and endoscopy are used to diagnose it. Treatment depends on the location but may include surgery, radiation, chemotherapy or palliation.
Ultrasound is useful for evaluating the pancreas and detecting complications of acute and chronic pancreatitis. In acute pancreatitis, ultrasound can identify changes in the pancreas such as areas of hypoechogenicity and peripancreatic inflammation. Complications like pseudocysts and vascular thromboses are also detectable. Chronic pancreatitis is characterized on ultrasound by ductal dilatation, calcifications, and changes in pancreatic echotexture. Differentiating chronic pancreatitis from pancreatic cancer can be challenging. CT or MRI may be needed when ultrasound findings are inconclusive or to further evaluate necrosis in acute pancreatitis.
The esophagus is a muscular tube that transports food from the pharynx to the stomach. Esophageal cancer most often occurs in the lower third of the esophagus. Risk factors include chronic irritation from smoking, alcohol, and hot foods. Symptoms include difficulty swallowing and weight loss. Diagnosis involves endoscopy with biopsy. Treatment depends on the stage but may include surgery, radiation, intubation or bypass for inoperable tumors. The prognosis remains poor due to late diagnosis but endoscopic screening of high risk patients such as those with Barrett's esophagus can detect early cancers with a better outlook.
The document discusses x-rays and how to read different types of x-rays including those of the gastrointestinal tract, biliary system, urogenital system, and vascular system. It provides details on how to analyze barium swallows, angiograms, and other imaging studies. The document also describes common conditions that are diagnosed using medical imaging like achalasia, hiatal hernia, and esophageal cancer.
The document discusses the embryology, anatomy, clinical features, investigations and imaging findings of acute pancreatitis. Regarding embryology, it describes how the pancreas develops from dorsal and ventral buds that fuse. For anatomy, it outlines the relationships of different parts of the pancreas. It also summarizes the etiology, pathophysiology and scoring systems used to classify severity of acute pancreatitis. Imaging findings on ultrasound, CT and MRI are summarized to diagnose and characterize acute pancreatitis and its complications.
This document provides an overview of the esophagus, including its anatomy, physiology, common diseases, and diagnostic testing. Key points include:
- The esophagus connects the pharynx to the stomach and propels food through peristaltic contractions. It has three sections - cervical, thoracic, abdominal.
- Gastroesophageal reflux disease is common, caused by backflow of gastric acid into the esophagus. Risk factors include obesity, smoking, diet.
- Esophageal tears can range from superficial mucosal tears to full perforations, which require urgent treatment due to risk of mediastinitis and sepsis.
- Diagnostic tests include barium swallow,
This document discusses various rectal diseases including prolapse, proctitis, polyps, benign lesions, and carcinoma. Rectal prolapse is classified as mucosal or full-thickness and can be caused by straining, weak pelvic floor muscles, or trauma from childbirth. Treatment depends on the type but may include injections, banding, or surgery. Proctitis is inflammation that can be caused by infection, radiation, or inflammatory bowel disease. Polyps are growths that can be removed endoscopically if small or via surgery if large. Benign lesions include endometriosis, hemangiomas, and neuroendocrine tumors. Rectal carcinoma is often treated with surgery such as anterior resection or
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3. From cricoid cartilage at C6 to gastric cardia (25cm).
Cervical, thoracic and abdominal portions
Passes diaphragm at T10
Has an upper sphincter, the cricopharyngeus and lower
sphincter at the region of esophageal hiatus of
diaphragm
Held loosely in the hiatus by thickened fascia, the
phreno-esophageal ligament.
3 C6
T10
4. Blood supply:
Inferior thyroid artery in cervical region
bronchial arteries, branches from
thoracic aorta
inferior phrenic and left gastric arteries
4
5. Venous drainage:
To inferior thyroid veins in the neck,
Hemi-azygous and azygous veins in
thorax
left gastric veins in abdomen
5
6. Nerve supply:
Sympathetic: from pre-ganglionic
fibres from T5 and T6
Post ganglionic fibres from cervical
vertebra, celiac ganglia
Parasympathetic: from glossopharyngeal,
recurrent laryngeal, vagus nerve
6
11. Oesophageal peristalsis is initiated by swallowing (primary) or luminal
distension (secondary) and progresses distally at around 2–4 cm/s
The lower sphincter relaxes momentarily 2–3 seconds before the
peristaltic wave arrives and pressures of about 80 mmHg. Disruption of
any part of this process can result in difficulties with swallowing and/or
pain.
11
12. Between the outer longitudinal muscle layer and the inner circular
layer is a nerve plexus (Auerbach’s or myenteric plexus) receiving
parasympathetic motor innervation to smooth muscle cells from
vagal nuclei.
Between the inner muscular layer and the submucosa is another
nerve plexus (Meissner’s or submucosal plexus), which relays signals
from the numerous free nerve endings in the mucosa and
submucosa to vagal afferent fibres. This sensory information is sent
back to the brain via the vagus nerve trunks.
12
13. 13
Lower oesophageal sphincter usually prevents
reflux by the following mechanisms:
a physiological high-pressure zone (not a true
sphincter) in the lower end of the oesophagus
the mucosal rosette at the cardia, which acts like a plug
the angle at which the oesophagus joins the stomach
between the left border of the oesophagus and the
fundus (angle of His)
the diaphragmatic sling (crura), which acts like a
pinchcock at the lower end of the oesophagus
the high-pressure area at the lower end of the
oesophagus, caused by the positive intra-abdominal
pressure.
15. Dysphagia
Difficulty in swallowing.
Onset:
Sudden foreign body
Over weeks carcinoma
Over years achalasia, benign strictures
Site correlates poorly with the site of obstruction
Progression:
Rapid in carcinoma
Slowly in achalasia
Severity:
Difficulty in swallowing solids initially carcinoma
If liquids initially achalasia
15
16. Table 16-1. CAUSES OF DYSPHAGIA
Intraluminal Intramural Extrinsic
Pharynx/upper oesophagus Foreign body Pharyngitis/tonsillitis Thyroid enlargement
Moniliasis Pharyngeal pouch
Sideropenic web
Corrosives
Carcinoma
Myasthenia gravis
Bulbar palsy
Body of oesophagus Foreign body Corrosives Mediastinal lymph nodes
Peptic oesophagitis Aortic aneurysm
Carcinoma
Lower oesophagus Foreign body Corrosives Para-oesophageal hernia
Peptic oesophagitis
Carcinoma
Diffuse oesophageal
spasm
Systemic sclerosis
Achalasia
Post-vagotomy
16
17. Impacted foreign bodies
Anatomical areas of narrowing:
Arches of the faucets
Vallecula
Piriform fossa
Cricopharyngeus
Where left bronchus crosses esophagus
Where the arches of aorta cross the esophagus
Diaphragm
Gastro-esophageal junction
Can present with severe distress, chest pain and retching.
There maybe perforation hematemesis, mediastinitis
17
18. Impacted foreign bodies
Investigation:
Chest X-ray – may show radio-opaque foreign body, perforation
Water-soluble contrast
Endoscopy
Management:
Conservative – ask patient to cough or by using Heimlich manoeuvre
Endoscopic removal – either by flexible endoscopy under sedation or rigid endoscopy
under general anesthesia
18
19. Achalasia
Failure of relaxation of the lower esophageal sphincter – as
disease progress, obstructed esophagus dilates and peristalsis
becomes uncoordinated
Due to partial or complete degeneration of the myentric
plexus of Auerbach and in later stages due to loss of dorsal
vagal nuclei.
Infestation with Trypanosoma cruzi
19
20. Achalasia
Clinical features:
30-40 age group, F > M
Progressive dysphagia over years – for both solids and liquids
Retrosternal pain – decreases gradually as esophagus loses peristaltic activity
Weight loss, halitosis, regurgitation, aspiration pneumonia, recurrent chest infection
Predispose to squamous cell carcinoma of esophagus
Investigations:
Barium swallow –
Dilatation of esophagus followed by tapered narrowing end
Chest X-ray –
Widened mediastinum, fluid level behind heart
Endoscopy
Esophageal manometry
20
23. Achalasia
Management:
Balloon dilatation of lower sphincter (risk of perforation)
Patients who require more than 2 dilatations should be considered for surgery
Endoscopic injection of gastro-esophageal junction with botulinum
toxin
Heller’s cardiomyotomy
Either thoracic or abdominal approach
Complications: perforation, reflux esophagitis, stricture, esophageal
diverticulum, recurrent dysphagia if inadequate myotomy done
To prevent perforation – abdominal approach preferred plus a partial
anterior fundoplication carried out
23
25. Plummer – Vinson Syndrome
Post-cricoid web that results in dysphagia.
The web is related to iron deficiency anaemia, but may be congenital or
traumatic in origin.
The squamous epithelium becomes hyperplastic and there is hyperkeratosis
and desquamation, which leads to web formation.
Clinical features
Middle-aged females
Dysphagia is the main presenting complaint,
Symptoms and signs of anaemia, including koilonychia, smooth tongue and
angular stomatitis
25
26. Plummer – Vinson Syndrome
Investigations
FBC hypochromic microcytic anaemia and serum ferritin levels
will be low.
Barium swallow narrowing of the upper oesophagus with a
web in the anterior wall
Endoscopy for confirmation
Management
Web is dilated endoscopically and biopsies should also be taken,
as there is an association with post-cricoid carcinoma.
Iron deficiency status is corrected by oral iron therapy.
26
28. Gastro-esophageal Reflux
Retrograde flow of gastric acid through an incomplete cardiac sphincter into lower
esophagus
Clinical features:
Heartburn – retrosternal burning pain, radiating to epigastrium and to neck
Regurgitation of acid contents into the mouth (waterbrash)
Dysphagia
28
29. Gastro-esophageal Reflux
Investigations:
Barium swallow and meal
Endoscopy - confirmatory
Ph monitoring and esophageal manometry
Ambulatory 24-hour pH monitoring – gold standard
Manometry exclude other motility disorders, to ensure
there is adequate muscular contraction
29
30. Gastro-esophageal Reflux
Management:
General
Weight loss, sleeping with additional pillows, raising head of the bed, avoid
smoking, coffee, alcohol
Medical
H2 receptor antagonists or proton pump inhibitor – reduces acid secretion
Metoclopramide improves esophageal muscle tone, promote gastric
emptying
Anti-reflux surgery
For those whose symptoms are not controlled with medical treatment, those
with recurrent strictures, young patients who do not wish to continue acid
suppression therapy
Most common: Nissen fundoplication
Others include: Toupet and Watson repairs
30
32. Tumors of Esophagus
Benign tumors:
< 1% of esophageal neoplasms
Most common is benign mixed stromal cell tumor (GIST)
Asymptomatic, may cause bleeding and dysphagia
Treated by local enucleation
32
33. Carcinoma of the esophagus
Male to female ratio is 3:1
Adenocarcinoma :
Predominantly a disease of western white males
Mostly lower and middle oesophagus (in Barrett’s oesophagus)
Risk factors: reflux, obesity
Squamous cell carcinoma :
Far East and black males
Risk factors: alcohol, smoking, leucoplakia, achalasia, consumption of
salted fish, chewing tobacco and betel nuts
33
34. Carcinoma of the esophagus
Clinical features:
Dysphagia that progresses from solids to liquids
Retrosternal pain on swallowing (odynophagia)
Regurgitation and aspiration pneumonia
Metastatic disease enlarged cervical nodes, jaundice,
hepatomegaly, hoarseness, chest pain
Investigations:
Confirmed by endoscopy and biopsy
Staging done by:
Endoscopic ultrasonography – for local tumor stage and
nodal spread
Chest X-ray, Abdominal ultrasound, CT – for distant
metastases
Routine blood tests
34
36. Carcinoma of the esophagus
Management:
Surgical resection
Patient with disease confined to the esophagus and who are fit
for surgery should be considered for resection.
1. Ivor Lewis two-phase esophagectomy
This involves a laparotomy during which the stomach is fully mobilized
on its vascular pedicles, along with the lower oesophagus.
Then, right thoracotomy to resect the oesophagus
The mobilized stomach is brought up into the chest and anastomosed to
the proximal oesophagus.
This is the preferred choice for middle and lower-third tumours
36
38. Carcinoma of the esophagus
Left thoracolaparotomy:
For tumors around the esophago-gastric junction.
Transhiatal esophagectomy:
Involves two surgeons, one operating through neck and the other in the abdomen
Stomach is mobilized as for the Ivor Lewis procedure and the oesophagus is mobilized
through the hiatus.
The surgeon operating in the neck mobilizes the upper oesophagus and extends the
dissection into the chest.
The stomach is brought up into the neck and anastomosed to the proximal oesophagus.
For elderly patients with lower oesophageal tumours, in whom a thoracotomy should
be avoided if possible
38
40. Complications
Chest infections
Adequate chest drainage, good analgesia and chest physiotherapy
Anastomotic leakage
in the first few days after surgery a technical failure (results from ischaemia in
the proximal part of the mobilized stomach.
Early re-operation and revision of the anastomosis is the treatment of choice.
Leaks that occur later well controlled by the chest drains, and provided the
patient remains stable, can be managed non-operatively by nutritional support,
antibiotics and nasogastric drainage.
Assessment of the anastomosis is obtained by water-soluble contrast swallow
and/or careful endoscopy.
40
41. Radiotherapy and Chemotherapy
Used with curative intent in patients not suitable for surgical
resection.
Post-operative radiotherapy and/or chemotherapy (adjuvant
therapy) provide no additional survival advantage in patients
with resectable disease
41
42. Palliation
For patients with extensive disease and who are
unfit for surgery.
Main aim is to relief symptoms particularly
dysphagia
Endoscopic dilatation
Stent insertion
Laser ablation
Radiotherapy and chemotherapy
Analgesia and terminal care
42