Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
|Section 9. Gastrointestinal Emergencies >|
Chapter 80. Esophageal Emergencies, Gastroesophageal Reflux Disease, and Swallowed Foreign Bodies
Sections: Esophageal Emergencies, Dysphagia, Chest Pain of Esophageal Origin, Esophageal Perforation, Swallowed Foreign Bodies, Acknowledgments, References.
Topics Discussed: esophageal disease.
Excerpt:"The complaints of dysphagia, odynophagia, or ingested foreign body
immediately implicate the esophagus. The esophagus also is often
the site of pathology in patients presenting with chest pain, upper
GI bleeding (see Chapter 78, Upper Gastrointestinal Bleeding), malignancy, and mediastinitis. Many diseases of
the esophagus can be evaluated over time in an outpatient setting,
but several, such as esophageal foreign body and esophageal perforation,
must be addressed emergently.The esophagus is a muscular tube approximately 20 to 25 cm long.
The majority of the esophagus is located in the mediastinum, posterior
and slightly lateral to the trachea, with smaller cervical and abdominal
components as well, as shown in Figure 80-1.
There is an outer longitudinal muscle layer and an inner circular
muscle layer. The upper third of the esophagus is made up of striated
muscle. From the lower half down, the esophagus is all smooth muscle
(including the lower esophageal sphincter). The esophagus is lined
with stratified squamous epithelial cells that have no secretory
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