Esophageal diverticula, or outpouchings, are not a very common occurrence; predominantly affecting the male population that is past their seventh decade of life (Khan, Ismail, & Van de Werke, 2012). There are two main types of diverticulum: the traction and the pulsion-type. The traction, also commonly known as the true diverticulum, herniate through all layers of the esophageal wall and are usually found opposite of the tracheal bifurcation. They are mostly the result of congenital disorders that cause scarring of the esophagus and certain diseases such as tuberculosis. These types of diverticulum are not as common as the pulsion-type (Bagheri et al., 2013). The pulsion, known also as the false diverticulum or pseudodiverticulum, involve only the mucosal or submucosal layers of the esophagus penetrating through the muscular layer. These diverticulum are almost always acquired; very rarely are they seen as a congenital abnormality (Bagheri et al., 2013).
Zenker’s diverticulum, also known as cricopharyngeal or pharyngoesophageal, belong in the family of pulsion-type diverticula and were first described as early as 1769 (Baron, 2014). It is the most common of all diverticula with a prevalence of 0.01-0.1% of the population and are seen much more frequently in men rather than women (Sincleair, 2013). Zenker’s diverticulum end up becoming the main diagnosis for 2% of all patients referred to a fluoroscopic study for nonspecific dysphagia (Sincleair, 2013). This type of outpouching forms in the Killian’s Triangle; a section between the inferior pharyngeal constrictor muscle and the cricopharyngeal muscle that has been proven to be rather weak compared to the rest of the pharynx and upper esophagus. Because of their location, Zenker’s ...
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...ndoscopic diverticulotomy did not gain popularity until the later half of the 20th century (Ferguson, 2011, p. 297). During this procedure, a diverticuloscope is inserted orally until it reaches the site of the outpouching. From this point, different surgeons will utilize different methods for treatment. Most commonly, an endoscopic linear cutting stapler is used, as in diverticular stapling. The muscular wall that divides the esophagus and diverticula is destroyed, causing the actual diverticula to become the new posterior wall of the esophagus (Ferguson, 2011, p. 296). A few other methods for dividing the aforementioned wall between the esophagus and the diverticula itself exist, but are not as common as the stapler. These include the use of carbon dioxide laser for cautery, the endoscopic harmonic scalpel, needle knife papillotome, and an argon plasma coagulator.
...h a type of surgery called Cholecystectomy. The Non-Surgical approaches are used only in specific situations such as when a patient’s condition prevents using an anesthetic. In such cases, Oral dissolution therapy is used.
Upper gastrointestinal bleeding originates in the first part of the GIT, affecting the esophagus, stomach or duodenum. The symptoms of upper GI bleeding are hematemesis, coffee ground vomiting, melena, hematochezia (maroon coloured stool) if the hemorrhage is severe, severe syncope, chest pain, shortness of breath and anemia. Esophageal varices, esophagitis, Mallory-Weiss tears, esophageal ulcers or even esophageal cancers may cause esophageal bleeding. Esophageal varices are defined as extremely dilated and tortuous sub-mucosal veins in the lower third of the esophagus. They are most often a consequence of portal hypertension, commonly secondary to liver cirrhosis. They are asymptomatic until they rupture leading to massive hemorrhage. Half of the cases of the rupture may subside spontaneously but however 20-30% die during the first attack. Treatments to stop bleeding due to this case include using elastic bands to tie off bleed...
Stomach, an organ belongs to the digestive system, plays an important role in human body. This J-shaped organ can be full with one liter of food. Stomach is located on left upper part of abdominal cavity, it connects the esophagus (upper) with the small intestine (below). To the left of the stomach, there is a spleen and to the right of it, we’ve got the liver. There are four sections of the stomach: cardia, fundus, body and pyloric. To control the openings into the stomach, the gastroesophageal sphincter relaxes and allowing food leave the stomach is the function of pyloric sphincter. The stomach wall has three layers of muscles that help it contracts in all direction to break food into smaller molecules. Moreover, this organ is lined by mucus coat to neutralize acid
The third step in the digestive system involves the esophagus. In this step the food move through the esophagus by a process called peristalsis. The esophagus is a long muscular tube that goes from the pharynx to the stomach. Peristalsis is when the esophagus muscles contact and relax pushing the food through the esophagus and down into the stomach (Robinson, 2014).
A common condition that is associated with GERD and LES problems is having a hiatal hernia. A hiatal hernia is when you have a larger than normal opening in the diaphragm where the esophagus passes through. Since this opening is larger, the stomach begins to enter this opening. When you eat, the stomach and esophagus ...
Diverticulosis is a disease from the diverticulum. This is when the colon wall is been outpunched through the mucosa. These are small mucosal herniation bulging via smooth muscle and layers of the intestine along vasa recta formed opening in colon’s wall. Diverticulitis causes is still unknown but develop after a micro or macro perforation of diverticulum. Peritonitis is an end result from an intestinal rupture in the case of a large perforation. Clinically, diverticulosis could be asymptomatic or symptomatic, they are uncomplicated with no evidence of bleeding or inflammation. Signs and symptoms includes palpable mass and tenderness mostly i...
This is a muscular narrow tube lined with stratified squamous epithelium that connects the pharynx to the stomach through the diaphragm. The walls of the oesophagus secrete mucus (lubricants) which helps in the process of swallowing through peristalsis movement, moving the food from the oesophagus into the stomach. (McGuiness, 2006).
The second type of dysphagia is called Esophageal dysphagia. This type dysphagia is characterized by the diminished ability to move food through the esophagus (Eisenstadt, pg. 18). This may cause chest pain or cause the patient to spit up their f...
The patient is a 75-year-old female who is brought to the ER because of some dizziness. She has a very complicated medical history of mitral valve prolapse, uterine fibromas having hysterectomy, a question of Ménière's disease, anxiety, hypertension, asthma, CVA in 1994 with mild right-sided residual weakness, urethral stenosis, recurrent UTIs, pulmonary embolism, and idiopathic afib she did presyncopal developed Equinox, a history of diverticulosis, and diverticulitis. The patient is admitted inpatient. It is to be noted initially there is a question of a syncopal episode. Troponins are negative. She is dehydrated with urinary specific gravity of 10:30, and she has positive nitrates and leukocytes. She was initially placed in the emergency
According to Jill Peaston, the diverticula normally forms in the weak areas of the lining of the bowel or according to Meerschaert, the colon wall. When one experiences constipation, this causes the colon wall or lining of the intestines to strain. According to Meerscharet, diverticular disease was first discovered in the United States where it is common to have low amounts of fiber in one’s diet. Meerscharet also exclaims that diverticular disease is rare in countries such as Asia and Africa because residents of those countries eat high amounts of fiber in their diets. The amount of fiber that one consumes can determine whether or not they will develop diverticular disease.
FS can illustrate bowel pathologies with regards to polyps, ulcers and inflammation. There is a camera attached to the scope with which images are acquired. In addition to this, interventions, such as drug administration, poly removal and biopsy acquisition, may all be conducted through the sigmoidoscope where applicable.
Diverticular disease of the colon is characterized by three conditions that are involved in the development of diverticula, or outpouchings, in the muscular wall of the large intestine. These diverticula form in areas of the colon that are weakened by waste, gas or liquid and usually appear in the sigmoid colon, which is an area of high-pressure. The three conditions that lead to the onset of the disease are diverticulosis, diverticulitis, and diverticular bleeding (West).
Figure 2: Esophagus (40x: H&E)- The esophagus is a muscular tube that links the pharynx with stomach allowing foods, liquids, and saliva to be carried to the stomach. The wall of the esophagus is formed by four layers: mucosa, submucosa, muscularis externa, and serosa. The mucosa is lined with nonkeratinized stratified squamous epithelium. Underneath this epithelium is the lamina propria, which is a
Furthermore, in the pig on the outside of the oesophagus it was lined with a moist pink tissue this is called the mucosa (WebMD, 2015). The oesophagus is known as a muscular tube which connects the pharynx to the stomach (WebMD, 2015). Diagrams show what was observed;
Diverticulosis is a very common digestive disease. It occurs when pouches or small sacs begin to form in the wall of the colon but without causing any complications or problems. “It is estimated that approximately twenty percent of all patients that develop diverticula, will have either inflammatory or bleeding episodes (Floch, 2004).” Diverticulitis on the other hand is when bacteria start to actually grow in one or a few of those small pouches called “Diverticula”, causing it to get inflammed and infected in the digestive tract. Studies have shown that divirticula can form all througout the colon however; the sigmoid colon which is the curved part of the large intestine closest to the rectum, is known for the most popular site for the diverticula