PART 19 — ESOPHAGUS

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Study use: Rapid revision of esophageal anatomy, dysphagia patterns, congenital anomalies, motility disorders, reflux and Barrett esophagus, inflammatory/infectious disease, perforation, variceal bleeding, foreign bodies, and esophageal cancer. Emergency and treatment points are intentionally concise and should be interpreted with airway status, hemodynamic stability, endoscopic findings, manometry, pathology, and clinical severity.

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Priority Guide: 🔴 Core / Must Know | 🟠 Important | 🟡 Additional

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🎯 High-Yield Overview

• Bird-beak distal taper → achalasia; corkscrew esophagus → distal esophageal spasm.
• Progressive solids → liquids dysphagia → structural obstruction/cancer until excluded; solids + liquids from early course → motility disorder.
• Achalasia → loss of inhibitory myenteric neurons → impaired LES relaxation + absent peristalsis; confirmation → high-resolution manometry.
• GERD → heartburn/regurgitation; alarm symptoms such as dysphagia, bleeding, or weight loss → EGD.
• Barrett esophagus → salmon-colored mucosa + intestinal metaplasia with goblet cells → adenocarcinoma risk.
• Atopy + food impaction + rings/furrows + ≥15 eosinophils/HPF → eosinophilic esophagitis.
• Candida → white plaques; HSV → punched-out ulcers; CMV → large linear/serpiginous ulcers with owl-eye inclusions.
• Retching + hematemesis → Mallory–Weiss; retching + severe chest pain/crepitus → Boerhaave syndrome.
• Cirrhosis + painless hematemesis → esophageal varices.
• SCC → tobacco/alcohol + upper/mid esophagus; adenocarcinoma → Barrett/GERD/obesity + distal esophagus.

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RED FLAGS: Inability to handle secretions, esophageal button battery/sharp object, caustic ingestion with airway symptoms, severe chest pain after vomiting/instrumentation, hematemesis with shock, or progressive dysphagia with weight loss requires urgent assessment.

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1. ESOPHAGEAL ANATOMY, DYSPHAGIA & CONGENITAL ANOMALIES

2. ACHALASIA, DISTAL ESOPHAGEAL SPASM & SYSTEMIC SCLEROSIS

3. DIVERTICULA, RINGS, WEBS & PLUMMER–VINSON

4. GERD, HIATAL HERNIA, BARRETT & EOSINOPHILIC ESOPHAGITIS

5. PILL, INFECTIOUS & CAUSTIC ESOPHAGITIS