Dr.Muthanna AlassalDr.Muthanna Alassal

MBChB FICMS(CTVS)MBChB FICMS(CTVS)Lecturer Al-kindy medical collegeLecturer Al-kindy medical college

Cardiothoracic and Vascular SurgeonCardiothoracic and Vascular Surgeon Cardiothoracic and Vascular DepartmentCardiothoracic and Vascular Department

Surgical Specialization HospitalSurgical Specialization HospitalMedical CityMedical City

BaghdadBaghdad

EsophagusEsophagusThe esophagus is a muscular tube that The esophagus is a muscular tube that starts as a continuation of the pharynx starts as a continuation of the pharynx and end as a cardia of the stomach.and end as a cardia of the stomach.

Its about 25cm length in adult, Its about 25cm length in adult, anatomically it can be divided into 3 anatomically it can be divided into 3 partsparts– Cervical part: it’s about 5 cm in length.Cervical part: it’s about 5 cm in length.– Thoracic part: This is approximately 20 Thoracic part: This is approximately 20

cm in length.cm in length.– Abdominal esophagus: it’s approximately Abdominal esophagus: it’s approximately

1-4 cm in length.1-4 cm in length.

The blood supply of esophagus.The blood supply of esophagus.Histology.Histology.Physiology.Physiology.

Clinical presentation of esophageal Clinical presentation of esophageal disorders:disorders:– Dysphagia.Dysphagia.– Pain.Pain.– Regurgitation.Regurgitation.– Loss of weight and cutchaxia and dehydration.Loss of weight and cutchaxia and dehydration.– Anemia.Anemia.

Investigations:Investigations:– RadiologicalRadiological..– Barium study.Barium study.– CT scan and MRI.CT scan and MRI.– Intra-esophageal ultrasonography.Intra-esophageal ultrasonography.– Esophagoscopy.Esophagoscopy.– Manometric study.Manometric study.

Esophageal anomaliesEsophageal anomalies

Congenital abnormalities:Congenital abnormalities:

Tracheo-esophageal fistula.Tracheo-esophageal fistula.Duplications of the esophagus.Duplications of the esophagus.Congenital esophageal stenosis.Congenital esophageal stenosis.Laryngo-Tracheo esophageal cleft.Laryngo-Tracheo esophageal cleft.Congenital short esophagus.Congenital short esophagus.Congenital achalaisa.Congenital achalaisa.Dysphagia lusoria.Dysphagia lusoria.

Tracheo esophageal fistulaTracheo esophageal fistula

Type A (85%): proximal atresia and distal Type A (85%): proximal atresia and distal Tracheo-esophageal fistulaTracheo-esophageal fistula

Tracheo esophageal fistulaTracheo esophageal fistula

Type B (7%) both proximal and distal atresiaType B (7%) both proximal and distal atresia

Tracheo esophageal fistulaTracheo esophageal fistula

Type C (3%): the H-type fistula.Type C (3%): the H-type fistula.

Tracheo esophageal fistulaTracheo esophageal fistula

Type D (1.5%): esophageal atresia with double Type D (1.5%): esophageal atresia with double fistula fistula

Tracheo esophageal fistulaTracheo esophageal fistula

Type E (0.4%): esophageal atresia with Type E (0.4%): esophageal atresia with proximal fistula proximal fistula

Tracheo esophageal fistulaTracheo esophageal fistula

Type F (0.1%): esophageal stenosisType F (0.1%): esophageal stenosis..

Tracheo esophageal fistulaTracheo esophageal fistula

Management:Management:

Clinical presentation of the common typeClinical presentation of the common typeDiagnosis.Diagnosis.Preoperative preparation.Preoperative preparation.

Surgical treatment.Surgical treatment.

Perforation of the esophagusPerforation of the esophagus Causes.Causes.Clinical manifestationClinical manifestation..TreatmentTreatment. .

Functional disorders of esophagus (motility Functional disorders of esophagus (motility disorders)disorders)

Achalasa.Achalasa.Hypermotility disorders.Hypermotility disorders.Motility disorders secondary to systemic Motility disorders secondary to systemic diseases.diseases.

AchalasiaAchalasia

Clinical presentationClinical presentationDiagnosis.Diagnosis.Treatment.Treatment.– MedicalMedical– SurgicalSurgical