By Gregory N. Postma, Peter C. Belafsky, Jonathan E. Aviv
Written through leaders within the rising region of transnasal esophagoscopy (TNE), this full-color atlas is the 1st accomplished how-to reference in this expertise. The authors outline the symptoms for the process, offer step by step directions on strategy, and describe the complete diversity of anatomy and pathology obvious in the course of TNE examinations. significant sections specialize in disease-specific functions of TNE, together with esophagitis, webs and earrings, hiatal hernia, Barrett's metaplasia, neoplasia, and miscellaneous esophageal difficulties comparable to overseas our bodies, diverticula, caustic accidents, and varices. greater than a hundred full-color endoscopic photographs depict either basic esophageal anatomy and abnormalities as obvious throughout the endoscope.
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Extra info for Atlas of Transnasal Esophagoscopy, Second Edition
When evaluating the integrity of a fundoplication, the endoscopist must first evaluate the distal esophageal mucosa to rule out esophagitis, dysplasia, carcinoma, and Barrett's esophagus (BE). The wrap zone may incorporate the distal esophagus and conceal the distal extent of a metaplastic segment or the entire region of a short segment BE. This can make postoperative fundoplication surveillance of BE and dysplasia more difficult. After evaluating the esophageal mucosa, the relationship between the gastroesophageal junction (GEJ) and the location of the wrap must then be assessed.
On endoscopy, they appear as mucosal-covered, slightly raised, discrete, bluish-colored lesions that may be mistaken for varices (Fig. 3). Biopsy may result in extensive hemorrhage (15). Inflammatory Pseudotumor Inflammatory pseudotumors of the esophagus are uncommon benign lesions of the esophageal lumen. On endoscopy, they are usually pedunculated masses located in the distal third (Fig. 4). They can enlarge, cause mucosal ulceration, and appear malignant. Biopsy is necessary to confirm the diagnosis (16).
Schatzki's rings, when measured radiographically, tend to be symptomatic if the opening is <13 mm. Those that leave an 18- to 20-mm lumen are nearly always asymptomatic. Dilation of the B-ring is successful in relieving the dysphagia. This may be 30 31 accomplished by mechanical dilation (bougienage) or disruption by pneumatic balloons using endoscopy or fluoroscopy. Care should always be taken when evaluating a patient using transnasal esophagoscopy because the smaller caliber endoscope may allow the examiner to miss esophageal rings, as well as mild strictures.
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