Hiatal hernias develop in 10% to 50% of the population with an average age of 48 for patients with a sliding hernia and 65 to 75 for a paraesophageal hernia. There are four types of hiatal hernias. Type 1, accounting…
Gastroesophageal Reflux Disease Gastroesophageal reflux is a normal occurrence involving the movement of gastric contents through the lower esophageal sphincter (LES) into the esophagus. Physiologic reflux is usually harmless until the process causes symptoms and physical changes in the esophagus;…
Eosinophilic esophagitis (EOE) is a chronic inflammatory disorder propagated by interleukin-5 (IL-5); it is unrelated to gastroesophageal reflux disease (GERD). Formerly a rare disease initially described in children and young men, EOE has been diagnosed more frequently in the past…
Esophageal varices are diagnosed in almost one-third of compensated cases and almost two-thirds of decompensated cases of cirrhosis. Bleeding may occur in one-third of cases and is related to the size of the varix and the severity of the liver…
Esophageal perforation and rupture may occur from small penetrations after endoscopy; full-thickness ruptures may follow from a tear or penetration. Presentation, diagnosis, and treatment are variable. The rarity of the diagnosis and variability in clinical presentation often lead to diagnostic…
Each year in the United States, 34,000 people ingest caustic substances ( Fig. 7.1 ), leading to tissue destruction through liquefaction or coagulation reactions. The severity of destruction depends on the type, concentration, and amount of substance; whether it is…
More than 100,000 cases of ingested foreign bodies occur in the pediatric population each year. Although most are accidental, intentional ingestion starts in adolescence. Children under 5 years of age are often exposed to random household objects, and they often…
Based on radiologic and endoscopic studies, esophageal diverticula have a prevalence of up to 3% of individuals. They may be classified according to cause (pulsion or traction), location (pharyngoesophageal, midesophageal, or epiphrenic), or wall component (full thickness [true diverticula] or…
Esophageal Rings and Webs Esophageal rings and webs are growths of tissue that partially obstruct the lumen of the esophagus. The prevalence of esophageal rings and webs has not been determined, as most patients are asymptomatic. Most lesions are found…
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