Esophageal Disease and Testing

by Bremner; Cedric G.

• ISBN13: 9780824728427
• ISBN10: 0824728424
• Format: Hardcover
• Copyright: 2005-08-23
• Publisher: CRC Press

Summary

"Promoting an improved understanding of the pathophysiology of esophageal diseases, this comprehensive guide reviews the use and interpretation of these tests and procedures for the investigation of esophageal anatomy and function ... studies imaging and endoscopic methods to detect superficial lesions, Barrett's esophagus and early stages of cancer ... imparts practical knowledge on the identification and effective management of esophageal disease."--BOOK JACKET.

Table of Contents

Preface	v
Radiology of the Esophagus	1	(34)
Introduction	1	(1)
Technique	2	(2)
General Comments	2	(1)
Motion Recording	2	(1)
Large Image Intensifier	2	(1)
Examination of the Stomach and Duodenum	2	(1)
Exam Details	2	(2)
Normal Appearance and Variants	4	(5)
Normal Variants	6	(2)
Normal Function	8	(1)
Hiatal Hernias	9	(4)
GERD	13	(5)
Segmental Narrowing	18	(4)
Motility Disorders	22	(7)
Achalasia	22	(7)
Postoperative Imaging	29	(6)
References	33	(2)
Esophageal Endoscopy	35	(12)
Endoscopy	35	(11)
Specific Indications	35	(1)
Normal Anatomy	36	(1)
Biopsies	37	(3)
Glycogenic Acanthosis	40	(5)
References	45	(1)
Esophagitis: Endoscopic Grading	46	(1)
References	46	(1)
Endoscopic Ultrasonography	47	(6)
Instrumentation	47	(1)
Uses	48	(2)
Other Uses	50	(1)
Carcinoma of the Esophagus and Esophagogastric Junction	50	(3)
Clinical Correlation	50	(1)
References	51	(2)
Esophageal Manometry	53	(92)
Indications for Esophageal Manometry	54	(1)
Esophageal Function Laboratory	54	(1)
Motility Laboratory Equipment	54	(1)
Patient Preparation and Passage of the Manometry Catheter	55	(5)
Patient Preparation	55	(1)
Manometry Catheter Insertion	55	(2)
Special Situations	57	(1)
Achalasia	57	(1)
Hiatal Hernia	58	(1)
Paraesophageal Hernia/Intrathoracic Stomach	58	(1)
Zenker Diverticulum	58	(1)
Epiphrenic and Mid-Esophageal Diverticulum	58	(1)
Passage and Position of Catheters for Ambulatory and pH Studies	59	(1)
Classification of Esophageal Manometric Abnormalities After Spechler and Castell	60	(1)
Barrier to Reflux: The Physiological Basis for Surgical Antireflux Therapy	60	(9)
History of Surgical Antireflux Therapy	60	(2)
Physiology of the Gastroesophageal Barrier	62	(4)
Causes and Consequences of the Failure of the Gastroesophageal Barrier	66	(2)
References	68	(1)
Lower Esophageal Sphincter	69	(3)
Standard Stationary Pull-Through Technique	69	(1)
Rapid Pull-Through Technique	70	(1)
Reproducibility of the Rapid Pull-Through Method	70	(1)
Motorized Pull-Through Method	70	(1)
Dent Sleeve	70	(1)
Measurement of the LES	70	(2)
References	72	(1)
Slow Motorized Pull-Through: An Improved Technique to Evaluate the LES	72	(5)
References	75	(2)
LES Relaxation	77	(2)
References	79	(1)
Transient Lower Esophageal Sphincter Relaxation	79	(1)
References	79	(1)
The Mechanically Defective LES	80	(1)
Hypertensive Lower Esophageal Sphincter	81	(2)
HLES with a Pressurized Esophagus	83	(1)
LES in Achalasia	83	(1)
References	83	(1)
Crural Pattern	84	(1)
Reference	85	(1)
Hiatal Hernia	85	(1)
Type I Hernia	85	(1)
References	86	(1)
Sliding Hiatal Hernia	86	(4)
Cartoon Description of the Evolution of a Sliding Hiatal Hernia	87	(1)
References	88	(1)
Motility Records Demonstrating Different Phases in the Development of a Sliding Hiatal Hernia	88	(1)
Different Motility Patterns of Sliding Hiatal Hernias	89	(1)
Reference	90	(1)
Double Respiratory Reversal	90	(1)
Intrathoracic Stomach	91	(1)
The Plateau Pressure	91	(1)
Reference	92	(1)
Esophageal Body	92	(1)
Normal Swallow Responses	93	(1)
References	94	(1)
Deglutitive Inhibition	94	(2)
References	96	(1)
Achalasia	96	(1)
Absence of Peristalsis is the Most Important Diagnostic Feature	96	(1)
Atypical Achalasia	96	(1)
Reference	97	(1)
Chagas' Disease	97	(2)
Diffuse (Distal) Esophageal Spasm	99	(1)
References	100	(1)
Hypercontractile (Nutcracker Esophagus)	100	(2)
References	102	(1)
Vascular Artifacts	102	(1)
Dysphagia Lusoria (From Latin Lusus Naturae: A Sport of Nature)	103	(1)
References	104	(1)
Ramp Intrabolus Pressure	104	(2)
References	106	(1)
Scleroderma of the Esophagus [Progressive Systemic Sclerosis (PSS)]	106	(1)
Reference	107	(1)
Mixed Connective Tissue Disease	107	(1)
Polymyositis and Dermatomyositis	107	(1)
References	107	(1)
Ineffective Esophageal Motility (IEM)	107	(2)
References	109	(1)
Nonspecific Esophageal Motor Disorder (NSEMD)	109	(1)
Cricopharyngeal Sphincter	110	(8)
Background	110	(1)
Proximal PES Assessment	111	(1)
Distal PES Including the Cricopharyngeal Muscle	111	(1)
Outflow Resistance and ``Compliance''	112	(1)
Normal Features of Cricopharyngeal Sphincter Manometry	112	(4)
Effects of a Myotomy	116	(1)
Normal Values	117	(1)
Advantages of Closely Spaced Water-Perfused Technique	117	(1)
Disadvantages	117	(1)
References	118	(1)
Evaluation of Recurrent Symptoms After Antireflux Surgery	118	(1)
References	119	(1)
Nissen Fundoplication Too Tight	119	(2)
Post Nissen Fundoplication: Recurrent Hernia with Intact Fundoplication	121	(1)
Post Nissen Fundoplication: Nutcracker Esophagus	122	(1)
Reference	122	(1)
Unusual Patterns	122	(9)
Achalasia with Hiatal Hernia	122	(1)
HLES and Nutcracker Esophagus	123	(2)
Hiatal Hernia with a HLES	125	(1)
End-Stage GERD	125	(1)
HLES with Pressurized Esophagus	126	(3)
Epiphrenic Diverticulum	129	(2)
Reference	131	(1)
Ambulatory Motility	131	(14)
Normal Patterns	132	(1)
Gastroesophageal Reflux Disease	133	(2)
Hypertensive LES	135	(1)
Achalasia	136	(1)
Reference	136	(3)
Diffuse Esophageal Spasm (DES)	139	(3)
Cough	142	(3)
Ambulatory pH Monitoring	145	(14)
Ambulatory pH Monitoring: Historical Milestones	145	(1)
References	145	(1)
Equipment	146	(1)
Electrodes	146	(1)
Recording Systems	146	(1)
Calibration	146	(1)
Patient Instructions	146	(1)
pH Test Diet	147	(1)
Scoring Systems	147	(3)
References	147	(1)
Patterns of Esophageal Acid Exposure to the Esophagus	148	(2)
Use of a Double pH Probe	150	(1)
Postprandial Gastroesophageal Reflux	150	(5)
Reference	155	(1)
Catheter-Free Ambulatory pH Monitoring: Historical Milestones	155	(1)
References	155	(1)
``Bravo™'' Probe (Medtronic, Inc.)	155	(4)
Equipment	155	(1)
Probe Insertion	156	(1)
Patient Instructions	157	(1)
Scoring System	157	(2)
Bilitec Monitoring	159	(8)
Spectrophotometry Apparatus	159	(1)
References	159	(1)
Patient Instructions	160	(3)
Foods that Can Be Eaten for the Bilitec 2000 Study	160	(3)
Normal Values for Esophageal Exposure to Bilirubin (35 Healthy Volunteers)	163	(1)
Patterns of Combined Esophageal and Gastric Bilitec Recording	164	(3)
References	165	(2)
Esophageal Impedance	167	(14)
Esophageal Impedance (Impedancometry)	167	(8)
Clinical Uses	167	(1)
Catheter Design	167	(1)
EFT Protocol	168	(4)
Bolus Clearance Patterns	172	(1)
Data Acquisition	173	(2)
Bolus Transport	175	(3)
Normal Values	175	(3)
Animated Display of Swallow Events	178	(3)
References	179	(2)
Index	181