1. Esophagus 2 Dr.Muthanna Alassal MBChB FICMS(CTVS)
Lecturer/ Al-kindy college of medicine
Cardiothoracic and Vascular Surgeon
Cardiothoracic and Vascular Department
Surgical Specialization Hospital
Medical City
Baghdad

2. Corrosive injury of the esophagus
Corrosive injuries of the esophagus are caused by ingestion of strong acid or alkali which is more serious, it could be accidental especially in children below 5 years old or suicidal or homicidal especially in adults.
the patient usually presented with:
Sever oral pain and ulceration of the mouth, pharynx and larynx.
drooling and excessive salivation
inability to swallow or to drink
hoarseness of voice
Aphonia, dyspnia, and stridor.

3. Corrosive injury of the esophagus
Management
History.
Chest X-ray.
Barium swallow & esophagoscopy.
Treatment
Induction of vomiting and dilution are forbidden.
Admittion to hospital.
Nil by mouth.
Correction of fluid and electrolytes disturbances.
Broad spectrum antibiotics.
Steroids.
Antacids.

4. Gastro-Esophageal Reflux Disease (GERD)
It s due to reflux of gastric juice (acid and pepsin) up t the esophagus leading to inflammation (esophagitis) at the lower end of the esophagus, this is mainly due to failure of the anti reflux barrier at the esophago gastric junction.
Predisposing factors
Obesity.
Aging process.
Hiatal hernia.
Previous surgery at the gastro esophageal junction

5. Gastro-Esophageal Reflux Disease (GERD)
Clinical manifestation
Chronicity.
Severity.
Age of the patient.
Diagnosis
Barium swallows.
Gastro esophago-dudonoscopy(OGD)
24hour PH monitoring of the esophagus.
Treatment

6. Hiatal Hernia Treatment
It is a herniation of part of the stomach through the esophageal hiatus to the thoracic cavity.
Types
Sliding (85%).
Rolling (Para esophageal type) (10%)
Mixed type (5%).
Clinical manifestation
Causes
Diagnosis.
Treatment

7. Tumors of the esophagus
Benign tumors
papilomas
polyps
lipomas
fibromas
leiomyomas
duplication cyst.
Foregut cyst.

8. Malignant tumors of esophagus
Primary: Carcinoma of the esophagus is a common tumor with high predilection in certain geographical areas (esophageal belt) which includes the northern part of Iraq, Iran and southern parts of Russia, with equal incidence in both sexes affecting people usually in their third decade of life
Etiology
Genetic factors.
Carcinogens.
Certain premalignant conditions.

9. Malignant tumors of esophagus Pathology
50% in the lower third of the esophagus.
17% in the middle third (thoracic part).
33% in the lower esophagus.
Clinical features
Progressive Dysphagia.
Progressive weight loss, catchaxia, dehydration, and anemia.
repeated chest infection.

10. Malignant tumors of esophagus Diagnosis
Radiological
Abdominal ultrasound.
Esophagoscopy.
Endoscopic ultrasonography (EUS).
Biochemical and blood studies.
Treatment
Palliative.
Definitive surgical treatment.

11. Malignant tumors of esophagus Palliative
bypass conduits.
Endoscopic stenting.
Self expandable recent stents.
Feeding jejunostomy or gastrostomy in advanced cases.
Definitive surgical
Left lower thoraco-abdominal approach.
Ivor lewis esophagectomy.
Trans-Hiatal esophagectomy.
Modified McKeowen or tri-incisional technique

12. Esophageal Diverticula
Miscellaneous
Esophageal Diverticula
Diverticulum is a pouch in the gastro intestinal tract.
Types
Pulsion diverticulum
Traction diverticulum
Clinical presentation
Diagnosis &Treatment

13. Plummer Vinson syndrome (Paterson Kelly syndrome)
Miscellaneous
Plummer Vinson syndrome (Paterson Kelly syndrome)
clinical features
Atrophy of the tongue.
Angular stomatitis.
Koilonychia(spoon shaped finger nails).
Hypochromic anemia.
Achlorhydria.
Treatment
Surgical dilatation of the stricture.
Iron replacement with other vitamins.