OESOPHAGUS

Oesophagus

Applied Anatomy

1. The oesophagus is a muscular tube extending from the pharynx to the stomach.
2. It is approximately 25 cm in length and 2.5 cm in diameter.
3. It is divided into cervical, thoracic, and abdominal parts.
4. The cervical part is 10 cm long and begins at the cricopharyngeal sphincter.
5. The thoracic part is 15 cm long and is the narrowest part of the oesophagus.
6. The abdominal part is 10 cm long and ends at the diaphragm.

Functions

1. The oesophagus is a muscular tube that propels food into the stomach through peristalsis.
2. It is lined with mucous membrane that helps to lubricate the passage of food.
3. It also has a sphincter mechanism at the upper and lower ends to prevent reflux.

Investigations

1. X-ray: Useful for detecting strictures, foreign bodies, and mediastinal masses.
2. Barium swallow: Useful for detecting strictures, hiatal hernia, and oesophageal carcinoma.
3. CT scan: Useful for detecting oesophageal carcinoma, mediastinal masses, and metastases.
4. Oesophagoscopy: Useful for detecting strictures, foreign bodies, and oesophageal carcinoma.

Dysphagia

1. Dysphagia is a symptom that is defined as difficulty in swallowing.
2. Aetiology:
   • Mechanical obstruction
   • Functional obstruction
   • Neurological disorders
3. Types of dysphagia:
   • Odynophagia: Painful swallowing
   • Globus sensation: Feeling of lump in the throat
   • Pharyngeal dysphagia: Difficulty in initiating swallowing
   • Esophageal dysphagia: Difficulty in propelling food through the oesophagus
4. Signs and symptoms:
   • Difficulty in swallowing
   • Choking sensation
   • Regurgitation of food
   • Weight loss
5. Differential diagnosis:
   • Oesophageal carcinoma
   • Stricture
   • Achalasia
   • Hiatal hernia
   • Gastroesophageal reflux disease
6. Investigations:
   • Endoscopy
   • Barium swallow
   • Manometry
   • CT scan

Stricture of Oesophagus

1. Aetiology:
   • Chronic gastroesophageal reflux disease
   • Ingestion of caustic substances
   • Oesophageal carcinoma
   • Radiotherapy
2. Clinical features:
   • Difficulty in swallowing
   • Choking sensation
   • Regurgitation of food
   • Weight loss
3. Investigations:
   • Endoscopy
   • Barium swallow
   • CT scan
4. Treatment:
   • Dilatation
   • Stricturectomy
   • Radiotherapy
   • Chemotherapy

Plummer-Vinson Syndrome

1. Aetiology:
   • Iron deficiency anemia
   • Chronic gastroesophageal reflux disease
   • Oesophageal carcinoma
2. Clinical features:
   • Dysphagia
   • Iron deficiency anemia
   • Esophageal web
3. Investigations:
   • Endoscopy
   • Barium swallow
   • Blood tests
4. Treatment:
   • Iron supplementation
   • Dilatation
   • Stricturectomy

Achalasia Cardia

1. Aetiology:
   • Degeneration of the myenteric plexus
   • Chronic gastroesophageal reflux disease
   • Oesophageal carcinoma
2. Clinical features:
   • Dysphagia
   • Regurgitation of food
   • Weight loss
3. Investigations:
   • Endoscopy
   • Barium swallow
   • Manometry
4. Treatment:
   • Pneumatic dilatation
   • Laparoscopic Heller myotomy
   • Peroral endoscopic myotomy

Carcinoma of Oesophagus

1. Aetiology:
   • Chronic gastroesophageal reflux disease
   • Oesophageal carcinoma
   • Smoking
   • Alcohol consumption
2. Clinical features:
   • Dysphagia
   • Regurgitation of food
   • Weight loss
3. Investigations:
   • Endoscopy
   • Barium swallow
   • CT scan
   • Biopsy
4. Treatment:
   • Surgery
   • Chemotherapy
   • Radiotherapy

Homoeopathic Treatment

1. Dysphagia:
   • Calcarea carbonica
   • Lycopodium clavatum
   • Pulsatilla
2. Stricture of oesophagus:
   • Calcarea carbonica
   • Silica
   • Natrum muriaticum

Blood Supply

1. The oesophagus receives its blood supply from the oesophageal arteries.
2. The cervical part is supplied by the inferior thyroid arteries.
3. The thoracic part is supplied by the bronchial arteries.
4. The abdominal part is supplied by the left gastric artery.

Nerve Supply

1. The oesophagus receives its nerve supply from the vagus nerve.
2. The cervical part is innervated by the pharyngeal plexus.
3. The thoracic part is innervated by the oesophageal plexus.
4. The abdominal part is innervated by the gastric plexus.

Clinical Anatomy

1. The oesophagus is a muscular tube that propels food into the stomach.
2. It is lined with mucous membrane that helps to lubricate the passage of food.
3. It also has a sphincter mechanism at the upper and lower ends to prevent reflux.
4. The oesophagus is divided into cervical, thoracic, and abdominal parts.