Еsophageal disease stricture diverticula

Clinical picture of esophageal diverticula
Food regurgitation might occur when standing, bending or lying down
Patients might develop dysphagia (difficulty swallowing)
Chronic coughing
Chest pain
Heartburn
Weight loss

Esophageal diverticula classification
By acuirence:
congenital
acquired
By quantity:
single
multiple
By localisation
crycopharyngeal (or Zencer)
midoesophageal
epiphrenic

Clinical picture of esophageal diverticula
As food collects in the pockets, it promotes bacteria in the esophagus, which also leads to halitosis (bad breath).
A patient’s voice also might change.

Diagnostic of esophageal diverticula
Esophagoscopy
Chest X-ray
Contrast esophagography

Chest X-ray

Diverticulectomy

Diverticulectomy

Diverticulectomy

Esophageal achalasia
A rare motor disorder of the esophagus characterized by inability of the lower esophageal sphincter and esophageal muscle to relax as well as dilation of the esophagus

Esophageal achalasia
clinical picture
Dysphagia (most common)
Regurgitation
Chest pain
Heartburn
Weight loss

Esophageal achalasia
classification
There are four stages:
Functional spasm with out gullet extension
Stable spasm with moderate gullet extension but peristalsis is saved
Scar changes of esophageal wall with pronounced its dilatation, peristalsis is absent
Pronounced gullet dilatation with its S-type bending and erosive esophagitis

Esophageal achalasia
diagnostic
Contrast esophagography (barium swallowing)
Fibroesophagoscopy
Manometry
Biopsy

Achalasia treatment
In 1 and 2 stage – conservative treatment with spasmolitics or its combination with submucose botex injection
In 1, 2 and 3 stage baloon dilatation is appropriable
In 3 and 4 stage – just only myotomy by Heller or Petrovskiy could be provided

Esophageal stricture
An esophageal stricture is a gradual narrowing of the esophagus, which can lead to swallowing difficulties.
The strictures are caused by scar tissue that builds up in the esophagus.

When the lining of the esophagus is damaged, scarring develops.
When scarring occurs, the lining of the esophagus becomes stiff.
In time, as this scar tissue continues to build up, the esophagus begins to narrow in that area.
Esophageal stricture

Esophageal stricture
clinical picture
Heartburn
Dysphagia
Odynophagia
Food impaction
Weight loss
Chest pain.

Esophageal stricture
diagnostic
Contrast esophagography (barium swallowing)
Fibroesophagoscopy
Biopsy

Esophageal stricture treatment
Dilation. The esophagus is stretched by passing a dilator or air-filled balloon is passed through a endoscope.
Repeated dilation may be necessary to prevent the stricture from returning.

Esophageal stricture treatment
If is performed if a stricture can't be dilated enough to allow solid food to pass through.
Surgery is also performed if repeated dilations do not keep these strictures from returning.

Esophageal bypass grafting
(Esophagoplasty)
Total colonoesophagoplasty
Total gastroesophagoplasty
Total jejunoesophagoplasty