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    Siriporn Pongpattarapak
    A patient develops respiratory distress after an esophagectomy, with a chest x-ray showing an infiltrate in the right middle lobe. This is most likely due to an esophagogastric anastomotic leak. A 30-year old female complains of dysphagia, and imaging shows a likely sqaumous cell carcinoma. A 54-year old male has dysphagia and chest symptoms after eating, with weight loss, likely due to malignancy.

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    Siriporn Pongpattarapak
    84 views16 pages
    A patient develops respiratory distress after an esophagectomy, with a chest x-ray showing an infiltrate in the right middle lobe. This is most likely due to an esophagogastric anastomotic leak. A 30-year old female complains of dysphagia, and imaging shows a likely sqaumous cell carcinoma. A 54-year old male has dysphagia and chest symptoms after eating, with weight loss, likely due to malignancy.

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    A patient develops respiratory distress after an esophagectomy, with a chest x-ray showing an infiltrate in the right middle lobe. This is most likely due to an esophagogastric anastomotic leak. A 30-year old female complains of dysphagia, and imaging shows a likely sqaumous cell carcinoma. A 54-year old male has dysphagia and chest symptoms after eating, with weight loss, likely due to malignancy.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    84 views16 pages

    Quiz

    Uploaded by

    Siriporn Pongpattarapak
    A patient develops respiratory distress after an esophagectomy, with a chest x-ray showing an infiltrate in the right middle lobe. This is most likely due to an esophagogastric anastomotic leak. A 30-year old female complains of dysphagia, and imaging shows a likely sqaumous cell carcinoma. A 54-year old male has dysphagia and chest symptoms after eating, with weight loss, likely due to malignancy.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 16

    Quiz

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    Approximately 24 hr after an uneventful transhiatal esophagectomy
    with a cervical esophagogastric anastomosis for esophageal carcinoma,
    the patient develops respiratory distress requiring emergent intubation.
    The postintubation chest radiograph shows an infiltrate in the Rt
    middle lobe. What is the likely etiology of this complication?

    A. Phrenic nerve injury


    B. Tracheal laceration
    C. Gastric outlet obstruction
    D. Esophagogastric anastomotic leak
    E. Recurrent laryngeal nerve injury
    A 30-year-old female complains of a 3-month history of dysphagia. The
    barium swallow and endoscopic ultrasound obtained are shown in figs.
    What is the likely etiology of the patient’s symptoms?

    A. Sqaumous cell carcinoma


    B. Congenital duplication cyst
    C. leiomyoma
    D. Fibrovascular polyp
    E. Benign stricture
    54-year-old male complains of dysphagia and a sticking sensation in his
    chest after meals. He also experiences regurgitation of undigested food
    and has lost 10 lbs in the last 2 months. A barium esophagogram is
    obtained and is shown in fig, the differential diagnosis should be
    considered in… 4 answers

    Malignancy
    Achalasia
    Chagas disease
    Stricture
    All of the following supply blood to the esophagus except:

    A. Internal thoracic artery


    B. Lt gastric artery
    C. Inferior thyroid artery
    D. Bronchial arteries
    E. Inferior phrenic artery
    Which of the following is true regarding the anatomy of the esophagus?

    A. The narrowest point of the esophagus is at the level of bronchoaortic constriction


    B. The Meissner plexus is located in the submucosa
    C. The Auerbach plexus is located between the longitudinal muscle and the adventitia
    D. The serosa is the strongest layer of the esophagus
    E. The outer longitudinal layer is an extension of the cricopharyngeus muscle
    Which of he following most likely contributes to GERD?

    A. Intra-abdominal LES length of 3 cm


    B. LES resting pressure of 12 mmHg
    C. Total LES length of 5 cm
    D. Thirty percent tertiary waveforms
    E. Attachment of the phrenoesophageal ligament 4 cm above the EGJ
    A healthy 45-year-old woman is seen with a 6-month history of
    worsening heartburn, regurgitation and dysphagia. Over-the-counter
    antacids have resulted in mild improvement in her symptoms. Which of
    the following is least likely to contribute to her symptoms?

    A. Presence of a hiatal hernia


    B. Cigarette smoking and alcohol consumption
    C. High-protein diet
    D. Obesity
    E. Abnormal peristalsis
    A 35-year-old woman has complaints of dysphagia, regurgitation and
    weight loss. Esophagography shows barrowing of the distal end of the
    esophagus and manometry studies show significant tertiary waveforms.
    The LES has high residual pressure on swallowing. Which of the
    following has not been implicated as a possible cause of her disease?

    A. Helicobacter pylori infection


    B. Severe emotional stress
    C. A parasitic infection
    D. Drastic weight reduction
    E. Degeneration of the Auerbach plexus
    A patient arrives at the ER 8 hrs after balloon dilation of her esophagus with
    complaints of dysphagia and chest pain. She was found to be febrile, tachycadia and
    normotensive. Esophagography showed “bird’s beak” narrowing and a leak at the
    distal end of the esophagus with contrast material in the left side of the chest. After
    fluid resuscitaiton and antibiotics, which of the following is the most appropriate
    management?

    A. NG tube decompression and observation


    B. Endoscopic evaluation of the injury and stenting
    C. Lt thoracotomy, primary repair, myotomy and drain placement
    D. Laparotomy, primary repair and gastrostomy tube placement
    E. Laparotomy, esophagectomy and cervical esophagogastrostomy
    Which of the following is a true diverticulum consisting of all layers of
    the esophageal wall?

    A. Zenker
    B. Parabronchial
    C. Epiphrenic
    D. Pharyngoesophageal
    E. Meckel
    A 60-year-old man has GERD and episodic dysphagia. An upper
    gastrointestinal contrast-enhance study shows a type 1 hiatal hernia
    and thin bandlike narrowing of the distal end of the esophagus. Which
    of the following is true of his condition?

    A. Oral dilation is the treatment of choice


    B. It is the result of hypertrophy of the circular muscle layer
    C. Endoscopic mucosal resection is recommended
    D. There is squamous mucosa above and below the narrowing
    E. Surgical resection is indicated
    A 65-year-old man has progressive dysphagia, halitosis and
    regurgitation of undigested food. Esophagography shows a diverticulum
    at the level of the cricothyroid cartilage. Which o the following is not
    true of the disease

    A. It is a false diverticulum
    B. It is more commonly seen on the left side of the esophagus
    C. It is the most common esophageal diverticulum
    D. It is a traction diverticulum
    E. It occurs in the Killian triangle
    An otherwise healthy 40-year-old man seeks treatment in the ER
    because of hematemesis after a night of binge drinking and retching.
    Which of the following is true of his condition?

    A. It is caused by a pulsion diverticulum


    B. Endoscopy should not be performed because of the increased risk for perforati
    C. Bleeding is from an arterial source
    D. Surgical resection is often required
    E. H.pylori infection is a known risk factor
    Which of the following is not true regarding esophageal motility?

    A. Primary waveforms are initiated after swallowing and are peristaltic


    along the length of the esophagus
    B. Primary waveforms can generate pressures from 40 to 80 mmHg
    C. Secondary waveforms are initiated by voluntary mechanisms and are peristaltic
    D. Tertiary waveforms are nonprogressive and nonperistaltic
    E. Tertiary waveforms represent uncoordinated contractions of smooth muscle
    and are responsible for esophageal spasm

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