| Question | Answer |
| What is the diffential diagnosis of dysphsgia? | -In the lumen of esophagus
-In the wall of esophagus
-Outside the wall of esophagus
-General |
| In the wall cause of dyspahagia | In the wall
inflammatory stricture,
caustic stricture,
achalasia,
tumour of oesophagus or gastric cardia,
pharyngeal pouch,
Plummer-Vinson syndrome,
diffuse oesophageal spasm,
scleroderma and oesophageal web |
| In the lumena and outside the wall cause of dyspahgia | Lumen-Foreign body
Outside lumen-
retrosternal goitre,
enlarged left atrium
bronchogenic carcinoma |
| General cause of dysphagia? | bulbar palsy,myasthenia gravis and hysteria |
| What is bulbar palsy? | impairment of function of the cranial nerves IX, X, XI and XII, which occurs due to a lower motor neuron lesion in the medulla oblongata or from lesions of the lower cranial nerves outside the brainstem. |
| What is pseudobulbar palsy? | impairment of function of cranial nerves IX-XII due to upper motor neurone lesions of the corticobulbar tracts in the mid-pons |
| Hx to focus on dyspagia | -onset
-degree of dyspagia-solid/liquid/nothing at all
Associated symptoms:
1. weight loss
2. dyspepsia qs
3. norturnal cough
4. hemetemsis
5. fatigue-anemia, upper gi bleed, PVS
6. brethlessness-a/bc/ap
7. neurological-sensation/upper limb |
| Early stoma complication? | HIROO-haemorrhage, ischemia, stoma retraction, obstruction(adhesion), high output(hypo K) |
| Delayed stoma complication? | FISH P2OD
Fistulae, intussusception, stenosis, parastoma hernia, prolapse, psychosexual, obstruction, dermatitis |
| what is the primary gold standard in diagnosing dysphagia? | barium swallow |
| List all the investigation of dysphagia | -CXray-simple, non invasive
-barium swallow-gold standard
-esophagoscopy-bx in carcinoma
-endoscopy u/s-staging
-CT/MRI-stage
-mannometry-strenght, coordination of perstalsis, pressure of spinchter
-pH monitoring
-Bronchoscopy |
| Risk of OGD procedure- | rare, 1/2000
1) Perforation to oesophagus or lining of stomach
2) bleeding
3) damage to teeth
4) risks associated with sedation
5) Aspiration |
| Early complication of partial gastrectomy | HADAR
H-haemorrahge
• Haemorrhage
• Acute pancreatitis
• Duodenal stump disruption
• Anastomotic leak
• Respiratory compromise |
| Late complication of partial gastrectomy | Dumping syndrome
• Bile reflux and vomiting
• Diarrhoea
• Recurrent stomal ulceration
• Metabolic abnormalities: iron deficiency, vit B12 deficiency |
