Siewert

  1. Q) False regarding CA Esophagus

    a) Siewert I treated as Esophageal cancer

    b) Siewert III treated as Gastric cancer

    c) Siewert II treated as Esophageal cancer or Merindino surgery

    d) Proximal margin in Esophagus is determined routinely to alter the management

    Answer

Management DES

Q) DES esophagus False in the management of this patient

a) Treatment is primarily medical management

b) Long myotomy necessary if surgery indicated

c) Dor's Fundoplication is recommended to prevent reflux

d) Endoscopic dilatation.

Answer  Q 30

 

Association of Carcinoma Esophagus

Q) Adenocarcinoma of esophagus is associated with which of the following? ( #All Esophagus MCQS) 

a) Achalasia cardia

b) Barrett's disease

c) Human Papilloma virus (HPV)

d) Alcohol use

Answer - b

Association of carcinoma esophagus is with a number of risk factors. Both squamous cell carcinoma and adenocarcinoma of esophagus have different etiologies

Risk factors for Adenocarcinoma are                                                        Risk factor for Squamous cell carcinoma are

  1. Tobacco                                                                                                   1. Alcohol
  2. GERD                                                                                                       2. tobacco 
  3. Obesity                                                                                                     3. Achalasia
  4. Barrett                                                                                                      4. Caustic injury of esophagus
  5. H/o previous radiation for breast cancer                                         5. Previous radiation of CA breast                

                                                                                                                             6. H/o head and neck cancer

                                                                                                                             7. Plummer vinson and tylosis

Achalasia is associated with both Adenocarcinoma and SCC ( Table 35.2 - Shackelford) 

Esophagus Length

Q) Length of Esophagus is 

 A. 20 cm
B. 25 cm
C. 30-35cm
D. 40cm

Length of esophagus is important in various resection surgeries as well as endoscopy


Answer

 b 25 cm

The length of esophagus  is anatomically defined as the distance between the cricoid cartilage and the gastric orifice. It ranges in adults from 22 to 28 cm (24 ± 5 SD),  last 3 to 6 cm of which are located in the abdomen.

The shortest distance between the cricoid cartilage and the celiac axis is the orthotopic route in the posterior mediastinum, being 30 cm. The retrosternal (32 cm) and the subcutaneous route (34 cm) proved to be longer

Deviations to the left 

Esophagus through out its length deviates to the left in superior mediastinum and lower posterior mediastinum.

Constrictions of esophagus

Cervical narrowest at c5/6

Thoracic T4-5

Abdominal

 

Ref Shackelford page 10

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