STRUCTURAL DISEASES

• HIATAL HERNIA Etiology:

  herniation of stomach into the mediastinum through oesophageal hiatus of the diaphragm
• HIATAL HERNIA Risk Factors:

  increased intraabdominal pressure (pregnancy, obesity)
• HIATAL HERNIA Classification:

  1. type I (sliding hiatal hernia),
  2. type II (paraesophageal hernia with fixed gastroesophageal junction),
  3. type III (combined sliding and paraesophageal hernia),
  4. type IV (other viscera herniate into mediastinum, commonly the colon)
• HIATAL HERNIA Pathogenesis:

  weakening of the phrenoesophageal ligament and dilatation of the diaphragmatic hiatus
• HIATAL HERNIA Clinical signs:

  GERD
• HIATAL HERNIA Symptoms:

  heartburn, regurgitation, chest pain, dysphagia, and respiratory symptoms.
• HIATAL HERNIA Complications:

  GERD, gastric volvulus, and strangulation of the stomach
• HIATAL HERNIA Diagnosis:

  x-ray, CT scan, or endoscopy
• HIATAL HERNIA Differential diagnosis:

  gastritis, peptic ulcers
• HIATAL HERNIA Management:

  lifestyle modifications, medication for GERD symptoms, and surgical repair for large paraesophageal hernias
• HIATAL HERNIA Treatment:

  surgical intervention (laparscopy)
• RINGS & WEBS Etiology:

  congenital, acquired, inflammatory
• RINGS & WEBS Risk Factors:

  age > 40 years
• RINGS & WEBS Classification:

  • B ring (narrowing ring at squamocolumnar mucosal junction),
  • Schatzki ring (distal rings with lumen diameter of <13mm),
  • cervical oesophageal webs
• RINGS & WEBS Clinical signs:

  food dysphagia (Schatzki = meat)
• RINGS & WEBS Complications:

  Plummer-Vinson syndrome (symptomatic proximal oesophageal webs + iron-deficiency anemia in middle-aged women)
• RINGS & WEBS Diagnosis:

  endoscopy
• DIVERTICULA = small, bulging pouches that can form in the lining of your digestive system
• DIVERTICULA Etiology:

  increased intraluminal pressure associated with distal obstruction (Zenker's diverticula: obstruction = stenotic cricopharyngeal muscle; hypopharyngeal herniation: Killian's triangle = near cricopharyngeal muscle)
• DIVERTICULA Classification:

  by location -> epiphrenic (false diverticula with herniation of mucosa and submucosa through muscular layer of oesophagus), hypopharyngeal, midesophageal
• DIVERTICULA Clinical signs:

  • Zenker's diverticula = dysphagia, halitosis, aspiration;
  • Epiphrenic diverticula =  achalasia, stricture, oesophageal hypercontractile disorders;
  • Midoesophageal diverticula = regurgitation
• DIVERTICULA Complications:

  oesophageal candidiasis, proximal oesophageal strictures
• DIVERTICULA Diagnosis:

  barium swallow, endoscopy, manometry
• DIVERTICULA Treatment:

  surgical diverticulectomy + cricopharyngeal myotomy, marsupialization
• TUMORS Risk Factors:

  reflux disease, Barrett’s metaplasia, smoking, alcohol consumption, caustic injury, and HPV infection
• TUMORS Classification:

  squamous cell carcinoma and adenocarcinoma
• TUMORS Clinical signs:

  food dysphagia, weight loss, tracheoesophageal fistulas, vocal cord paralysis
• TUMORS Symptoms:

  odynophagia, iron-deficiency
• What is the etiology of hiatal hernia?

  Hiatal hernia occurs due to the herniation of the stomach into the mediastinum through the oesophageal hiatus of the diaphragm.
• What are the risk factors associated with hiatal hernia?

  Risk factors include conditions that increase intraabdominal pressure, such as pregnancy and obesity.
• How is hiatal hernia classified?

  Hiatal hernia is classified into four types: type I (sliding hiatal hernia), type II (paraesophageal hernia with fixed gastroesophageal junction), type III (combined sliding and paraesophageal hernia), and type IV (other viscera herniate into the mediastinum, commonly the colon).
• What is the pathogenesis of hiatal hernia?

  The pathogenesis involves weakening of the phrenoesophageal ligament and dilatation of the diaphragmatic hiatus.
• What are the clinical signs associated with hiatal hernia?

  Clinical signs include gastroesophageal reflux disease (GERD).
• What symptoms are commonly observed in patients with hiatal hernia?

  Symptoms may include heartburn, regurgitation, chest pain, dysphagia, and respiratory symptoms.
• What are the potential complications of hiatal hernia?

  Complications include GERD, gastric volvulus, and strangulation of the stomach
• How is hiatal hernia diagnosed?

  Diagnosis typically involves imaging studies such as x-ray, CT scan, or endoscopy.
• What conditions should be considered in the differential diagnosis of hiatal hernia?

  Gastritis and peptic ulcers are common differential diagnoses for hiatal hernia
• What are the treatment options for hiatal hernia?

  Treatment may involve lifestyle modifications, medication for GERD symptoms, and surgical repair for large paraesophageal hernias.
• What are the etiological factors associated with rings and webs in the oesophagus?

  Rings and webs in the oesophagus can be congenital, acquired, or inflammatory in origin.
• What age group is commonly affected by rings and webs in the oesophagus?

  Individuals aged over 40 years are at higher risk for developing rings and webs in the oesophagus.