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Universidad de Guadalajara
Septiembre 2011
EsophagealEsophageal PathologyPathology
Centro Universitario Ciencias de la Salud
Clínicas Quirúrgicas
Mayra C. Silva Camarena206558747
Dr. Benjamin Robles MariscalDr. Héctor Manuel Virgen Ayala
AnatomyAnatomy
40-45 cm
aortic arch aortic arch
left main left main bronchiole bronchiole
esophageal esophageal hiatus hiatus
HHistology
Physiologyhysiology
Motor funcion
UpperUpper Esophageal Esophageal SphincterSphincter
LowerLower Esophageal Esophageal SphincterSphincter
EsophagealEsophageal BodyBody
Gastroesophageal reflux diseasedisease
75% of esophageal diseasesdiseases
20-40% of the adultadult population suffers
PPathogenesisathogenesis
Retrograde reflux of gastric contents into the esophagus, which produces symptoms
and damages the mucosa
Transient relaxation
Hiatal hernia
secondary to gastric abnormalities
Clinical Manifestations
Pyrosis Regurgitation
Dysphagia
Cough Nausea Vomiting Postprandial Fullness Drowning Wheezing Chest pain Dysphonia Dental erosions
Differential diagnosis
Irritable bowel syndrome
Achalasia
Cholelithiasis
Coronary Coronary artery disease
Complications
NoneErosive esophagitis
StenosisBarrett's Esophagus
58%
23%
11%0%
42%77%89%
100%
Esophagitis
Grade 1Grade 2
Grade 3Grade 4
TTreatment
Changes in lifestyle
Medical Treatment
Surgical treatment
Surgical treatment
1Restore the LES pressure and length
2Sphincter placement in the abdomen
3Allow the cardia to relax during deglution
4Not increase the resistance of the sphincter above the capacity peristaltic esophageal body
5Allow the fundoplication is in place
Nissen fundoplication
Toupet Funduplication
Belsey Mark Funduplication
Gastroplasty
Nissen fundoplication
FForecastorecast
ControlControl
Characteristic 90%
Atypical 70%
Hiatal hernia
Type IType IIType III
Hiatal hernia
Type I
Type IIType III
Hiatal hernia
Type I
Type II
Type III
Symptoms
Pyrosis Regurgitation
Mechanical failure of the LES have
IDysphagia Postprandial fullness Anemia Dyspnoea Pneumonia
II
Diagnosis
X-ray
Barium test
Esophagoscopy
Diagnosis
X-ray
Barium test
Esophagoscopy
Diagnosis
X-ray
Barium test
Esophagoscopy
Treatment
ParasternalRetrosternal
Pleuroperitoneal Hernia
Morgagni
BochdalekBochdalek
Traumatic Diaphragmatic Hernia
Clinical Manifestations
Acute Chronic
Bibliography
G. M. Doherty. “Diagnóstico y tratamiento Quirúrgicos”, thirteenth edition, México; 2006. Page. 366-367; 375-388
F. C. Brunicardi, “Principios de Cirugia” , octave edition, Mexico; 2004.
Page.860-872;916-923.