Esophagus Dr.Muthanna Alassal MBChB FICMS(CTVS) Lecturer Al-kindy medical college Cardiothoracic and Vascular Surgeon Cardiothoracic and Vascular Department Surgical Specialization Hospital Medical City Baghdad
Esophagus • The esophagus is a muscular tube that starts as a continuation of the pharynx and end as a cardia of the stomach. • Its about 25cm length in adult, anatomically it can be divided into 3 parts • Cervical part: it’s about 5 cm in length. • Thoracic part: This is approximately 20 cm in length. • Abdominal esophagus: it’s approximately 1-4 cm in length. • The blood supply of esophagus. • Histology. • Physiology.
Clinical presentation of esophageal disorders: • Dysphagia. • Pain. • Regurgitation. • Loss of weight and cutchaxia and dehydration. • Anemia. • Investigations: • Radiological. • Barium study. • CT scan and MRI. • Intra-esophageal ultrasonography. • Esophagoscopy. • Manometric study.
Esophageal anomalies Congenital abnormalities: • Tracheo-esophageal fistula. • Duplications of the esophagus. • Congenital esophageal stenosis. • Laryngo-Tracheo esophageal cleft. • Congenital short esophagus. • Congenital achalaisa. • Dysphagia lusoria.
Tracheo esophageal fistula Type A (85%): proximal atresia and distal Tracheo-esophageal fistula
Tracheo esophageal fistula Type B (7%) both proximal and distal atresia
Tracheo esophageal fistula Type C (3%): the H-type fistula.
Tracheo esophageal fistula Type D (1.5%): esophageal atresia with double fistula
Tracheo esophageal fistula Type E (0.4%): esophageal atresia with proximal fistula
Tracheo esophageal fistula Type F (0.1%): esophageal stenosis.
Tracheo esophageal fistula Management: • Clinical presentation of the common type • Diagnosis. • Preoperative preparation. • Surgical treatment.
Perforation of the esophagus • Causes. • Clinical manifestation. • Treatment. Functional disorders of esophagus (motility disorders) • Achalasa. • Hypermotility disorders. • Motility disorders secondary to systemic diseases.
Achalasia • Clinical presentation • Diagnosis. • Treatment. • Medical • Surgical