dd’s of esophageal stricture and intra luminal filling defects

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Page 1: Dd’s of esophageal stricture and intra luminal filling defects
Page 2: Dd’s of esophageal stricture and intra luminal filling defects

Begins at level of C6 and ends at T11. 25cm long 3 constrictions

at cricoid cartilage at aortic arch & left main bronchus where it crosses diaphram

Page 3: Dd’s of esophageal stricture and intra luminal filling defects
Page 4: Dd’s of esophageal stricture and intra luminal filling defects

Four anatomical segments for staging purposes

.Cervical Esophagus .Upper Thoracic Esophagus .Middle Thoracic Esophagus .Lower Thoracic Esophagus

Page 5: Dd’s of esophageal stricture and intra luminal filling defects

An esophageal stricture is a narrowing or tightening of the esophagus that causes swallowing difficulties.

Page 6: Dd’s of esophageal stricture and intra luminal filling defects

Esophageal stricture can be caused by:

1.Benign1.BenignGastroesophageal reflux (GERD)Injuries caused by an endoscopeLong-term use of a nasogastric (NG) tubeIngestion of corrosives.Treatment of esophageal varices

Page 7: Dd’s of esophageal stricture and intra luminal filling defects

Symmetric tapered benign stricture months after radiotherapy.

Page 8: Dd’s of esophageal stricture and intra luminal filling defects

high stricture (arrow) following caustic ingestion.

Page 9: Dd’s of esophageal stricture and intra luminal filling defects

Corrosive ingestion can result in multiple strictures.

Page 10: Dd’s of esophageal stricture and intra luminal filling defects

CT showing thick walled esophagus with stenosis of the lumen.

Page 11: Dd’s of esophageal stricture and intra luminal filling defects

MALIGNANTSquamous cell carcinomaadenocarcinoma

Page 12: Dd’s of esophageal stricture and intra luminal filling defects

On the far left a stricture (arrow) with irregular mucosal folds at stricture site on air-contrast view. This patient had Barrett's esophagus. Mid esophageal strictures and ulcers are suspicious for Barrett's esophagus.

The two images on the right show a Barrett's esophagus with an irregular stricture due to adenocarcinoma

Page 13: Dd’s of esophageal stricture and intra luminal filling defects

Typical symptoms include;Dysphagia:Odynophagiaunintended weight lossregurgitation of food or liquids:HeartburnChokingBad taste in mouthhiccups

Page 14: Dd’s of esophageal stricture and intra luminal filling defects

Barium Swallow Esophageal PH monitoring CT Scan Endoscopy Biopsy

Page 15: Dd’s of esophageal stricture and intra luminal filling defects

Heart burn Malnutrition Dehyadration Choking Aspiration Pneumonia

Page 16: Dd’s of esophageal stricture and intra luminal filling defects

On the left images of a patient with a benign stricture high in the esophagus (arrow). There is bilateral lower lobe lung consolidation due to repeated aspiration.

Page 17: Dd’s of esophageal stricture and intra luminal filling defects

INTRALUMINAL FILLING DEFECTS

Page 18: Dd’s of esophageal stricture and intra luminal filling defects

Food impaction behind a stricture. Bezoar. Foreign body.

Page 19: Dd’s of esophageal stricture and intra luminal filling defects

Polyps Lieomyoma-smooth ,rounded indentation. Carcinoma-irregular filling defect usually

with a stricture.

Page 20: Dd’s of esophageal stricture and intra luminal filling defects

Esohageal polyps.

Page 21: Dd’s of esophageal stricture and intra luminal filling defects

Leiomyoma esophagus.

Page 22: Dd’s of esophageal stricture and intra luminal filling defects

Filling defect of esophagus on barium meal with typical proximal &distil shouldering.

Page 23: Dd’s of esophageal stricture and intra luminal filling defects

Irregular filling defect showing neoplastic growth.

Page 24: Dd’s of esophageal stricture and intra luminal filling defects

Filling defect on barium meal.

Page 25: Dd’s of esophageal stricture and intra luminal filling defects

CA bronchus. Mediastinal lymphadenopathy. Aortic aneurysm Anomolous right subclavian artery.

Page 26: Dd’s of esophageal stricture and intra luminal filling defects

 mediastinal nodes (arrows) that displace the esophagus to right in a patient with bronchogenic carcinoma

Page 27: Dd’s of esophageal stricture and intra luminal filling defects

Aberrant right subclavian artery

This is the most common thoracic arterial anomaly and rarely causes symptoms. The artery extends up and to the right producing a dorsal diagonal impression on the esophagus (arrows). The CT demonstrates that the aberrant artery (arrow) is last vessel from arch and extends dorsal to trachea and esophagus.

Page 28: Dd’s of esophageal stricture and intra luminal filling defects