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Esophageal Disorders

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Boerhaave Syndrome

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Clinical features: Severe chest pain, vomiting, and subcutaneous emphysema. Diagnosis: Contrast esophagram showing leakage of contrast, CT scan, and endoscopy. Treatment: Surgical repair and drainage, intravenous antibiotics, and nil by mouth.

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Gastroesophageal Reflux Disease (GERD)

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Clinical features: Heartburn, regurgitation, and dysphagia. Diagnosis: Clinical criteria, upper endoscopy, and pH monitoring. Treatment: Lifestyle changes, proton pump inhibitors, and surgery in refractory cases.

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Barrett's Esophagus

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Clinical features: Often asymptomatic but may have GERD symptoms. Diagnosis: Endoscopic biopsy showing intestinal metaplasia. Treatment: Surveillance endoscopy, acid suppression therapy, and treatment of dysplasia.

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Eosinophilic Esophagitis

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Clinical features: Dysphagia, food impaction, and atopic disease history. Diagnosis: Esophageal biopsy with eosinophilic infiltration. Treatment: Dietary management, proton pump inhibitors, and topical steroids.

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Plummer-Vinson Syndrome

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Clinical features: Dysphagia, iron-deficiency anemia, and esophageal webs. Diagnosis: Barium swallow shows web formation, blood tests show iron deficiency. Treatment: Iron supplementation, esophageal dilation, and monitoring for squamous cell carcinoma.

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Achalasia

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Clinical features: Progressive dysphagia, regurgitation of undigested food, and chest pain. Diagnosis: Esophageal manometry, barium swallow, and endoscopy. Treatment: Pneumatic dilation, surgical myotomy, and botulinum toxin injections.

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Esophagitis

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Clinical features: Odynophagia, dysphagia, and chest pain. Diagnosis: Endoscopic findings and histological examination. Treatment: Depends on etiology but generally includes acid suppression and anti-infective agents.

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Mallory-Weiss Tear

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Clinical features: Hematemesis following episodes of severe retching or vomiting. Diagnosis: Upper endoscopy showing a longitudinal mucosal laceration. Treatment: Supportive care, acid suppression therapy, and endoscopic hemostatic treatment if needed.

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Esophageal Stricture

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Clinical features: Gradual dysphagia, food impaction, and weight loss. Diagnosis: Barium swallow and endoscopic evaluation. Treatment: Esophageal dilation and management of underlying cause.

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Esophageal Varices

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Clinical features: Asymptomatic until rupture which leads to hematemesis and melena. Diagnosis: Upper endoscopy. Treatment: Band ligation, beta-blockers, and management of underlying liver disease.

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