Презентация Еsophageal disease stricture diverticula

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 ЕЕ sophageal disease (stricture,  diverticula, achalasia) Surgery department № 2№ 2 , , DSMA ЕЕ sophageal disease (stricture, diverticula, achalasia) Surgery department № 2№ 2 , , DSM

 Clinical picture of esophageal diverticula Food regurgitation might occur when standing, bending or lying down Clinical picture of esophageal diverticula Food regurgitation might occur when standing, bending or lying down Patients might develop dysphagia (difficulty swallowing) CC hronic coughing CC hest pain HH eartburn WW eight loss

 Esophageal diverticula classification By acuirence:  congenital  acquired By By quantity : : Esophageal diverticula classification By acuirence: congenital acquired By By quantity : : single mm ultiple By localisation crcr yy copharyngeal (or Zencer) midoesophageal epiphrenic

 Clinical picture of esophageal diverticula As food collects in the pockets, it promotes bacteria in 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 Diagnostic of esophageal diverticula Esophagoscopy Chest X-ray Contrast esophagography

 Chest X-ray Chest X-ray

 Diverticulectomy Diverticulectomy

 Diverticulectomy Diverticulectomy

 Diverticulectomy Diverticulectomy

 Esophageal achalasia A rare motor disorder of the esophagus characterized by inability of the lower 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 clinical picture Dysphagia (most common) Regurgitation Chest pain Heartburn Weight loss

 Esophageal achalasia classification There are four stages: 1. 1. Functional spasm with out gullet extension Esophageal achalasia classification There are four stages: 1. 1. Functional spasm with out gullet extension 2. 2. Stable spasm with moderate gullet extension but peristalsis is saved 3. 3. Scar changes of esophageal wall with pronounced its dilatation, peristalsis is absent 4. 4. Pronounced gullet dilatation with its S-type bending and erosive esophagitis

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

 Achalasia treatment In 1 and 2 stage – conservative treatment with spasmolitics or its combination 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 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 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 DD ysphagia OO dynophagia FF ood impaction WW eight loss Esophageal stricture clinical picture Heartburn DD ysphagia OO dynophagia FF ood impaction WW eight loss CC hest pain.

 Esophageal stricture diagnostic Contrast esophagography (barium swallowing) Fibroesophagoscopy Biopsy Esophageal stricture diagnostic Contrast esophagography (barium swallowing) Fibroesophagoscopy Biopsy

 Esophageal stricture treatment   Dilation. The esophagus is stretched by passing a dilator or 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 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 Esophageal bypass grafting (Esophagoplasty) Total colonoesophagoplasty Total gastroesophagoplasty Total jejunoesophagoplasty

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