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Achalasia Summary

Epidemiology: 10 cases per 100,000 individuals

Defined by inadequate relaxation of the LES and aperistalsis
Primary or
diseases that cause esophageal ... Other esophageal ... Treatment: Laparoscopic ... pneumatic dilation, laparoscopic ... management #treatment #gastroenterology
Diagnosis and Management of Achalasia - ACG Guidelines

Who to suspect?
 • Patients presenting with progressive dysphagia
High resolution esophageal ... Dilation (PD) • Laparoscopic ... ACG #Guidelines #gastroenterology
Chicago Classification of Esophageal Motility Disorders
Achalasia
EGJ Outflow Obstruction
Distal Esophageal Spasm
Jackhammer Esophagus
Absent Contractility
Ineffective Motility
Rapid Contraction

#Chicago #Classification #Esophageal
Classification of Esophageal ... Obstruction Distal Esophageal ... Classification #Esophageal ... Motility #Disorders #gastroenterology
Achalasia Management Algorithm
 - Botulinum Injection
 - Pharmacotherapy (CCB/nitrates)
 - Pneumatic Dilation
 - Peroral Endoscopic Myotomy
Myotomy (POEM) - Laparoscopic ... Management #Algorithm #gastroenterology
Management of Jackhammer Esophagus or Esophageal Spasm
Step 1: Assess the severity of the motility disturbance
Step 2:
Jackhammer Esophagus or Esophageal ... Jackhammer #Esophagus #Esophageal ... Spasm #Management #gastroenterology
Dysphagia - Differential Diagnosis Algorithm
Oropharyngeal - Can't initiate swallow, Cough/nasal regurg when attempting to swallow
Esophageal
attempting to swallow Esophageal ... Intermittent: Diffuse Esophageal ... Non-Progressive: Esophageal ... solids #liquids #gastroenterology
Oropharyngeal and Esophageal Causes of Dysphagia - Differential Diagnosis
Oropharyngeal Dysphagia
 • Neuromuscular causes: CVA/CNS tumor/ALS, Parkinson's,
Oropharyngeal and Esophageal ... 4 T's), Goiter Esophageal ... Fragmented Peristalsis, Esophageal ... Oropharyngeal #Esophageal ... Diagnosis #causes #gastroenterology
Boerhaave Syndrome on Endoscopy
Another spontaneous esophageal perforation (Boerhaave Syndrome) with gross mediastinal soiling from retching a
Another spontaneous esophageal ... Endoscopy #EGD #esophageal ... perforation #clinical #gastroenterology
Acute Esophageal Necrosis
History: Hematemesis and/or melena (70%), Dysphagia, Epigastric/chest pain, Sepsis
Diagnosis EGD and Biopsy
Differential: Melanosis, Melanoma,
Acute Esophageal ... KBrag_MD #Acute #Esophageal ... diagnosis #management #gastroenterology
Acute Esophageal Necrosis (Black Esophagus) on Endoscopy

Dr. Joaquín Berrueta Mezzera @DrJBerrueta

#Acute #Esophageal #Necrosis #Black #Esophagus #Endoscopy
Acute Esophageal ... DrJBerrueta #Acute #Esophageal ... Endoscopy #EGD #gastroenterology