The Esophagus E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 2721

Veröffentlichungsjahr: 2021

Beschreibung

THE ESOPHAGUS The Esophagus investigates the anatomy, physiology, and pathology of the esophagus. This sixth edition, revised and updated throughout, also explores the diagnosis and treatment of various esophageal conditions. It includes treatment guidelines approved by the two largest gastroenterology societies, the ACG and AGA, as befits a work co-edited by two former presidents of those organizations. Advancements in diagnostics are presented, as are developments in the surgical and drug therapies. Presented in full colour, and boasting an unrivalled team of editors and contributing authors, The Esophagus Sixth Edition will find a home wherever the anatomy, physiology, and pathology of the esophagus are studied and taught. This book is accompanied by a website containing all the figures from the book in PowerPoint format. www.wiley.com/go/richter/esophagus6e Praise for the Fifth Edition: "There is absolutely no doubt that this edition of the textbook will maintain its status as the go-to reference for esophageal conditions, and will remain a highly utilized and clinically useful resource for novice and experienced physicians and surgeons alike." (Gastroenterology, 1 July 2013)

Leseprobe

Table of Contents

Cover

Title Page

Copyright Page

Dedication Page

Contributors

Preface

About the Companion Website

PART I: Esophageal Symptoms

1 Symptom Overview and Quality of Life

Introduction

Esophageal anatomy and production of symptoms

Symptoms

Healthcare utilization and quality of life

Conclusion

References

2 Diagnosis and Treatment of Esophageal Chest Pain

Introduction

Epidemiology

Gastroesophageal reflux

Esophageal hypersensitivity

Dysmotility

Available treatment options for esophageal chest pain

Conclusion

References

3 Disorders Causing Oropharyngeal Dysphagia

Introduction

Swallowing

Presentation

Evaluation

Management

Conclusions

References

4 The Esophagus

Introduction

Definition, clinical presentation, and demographic characteristics

Differential diagnosis

Pathophysiology

Diagnosis

Treatment

Conclusion

References

PART II: Esophageal Physiology and Testing

5 Functional Anatomy and Physiology of Swallowing and Esophageal Motility

Introduction

Swallowing

Upper esophageal sphincter

Esophageal stage motor activity

Lower esophageal sphincter

References

6 Radiology of the Pharynx and Esophagus

Introduction

Pharynx

Esophagus

References

7 Special Endoscopic Imaging and Optical Techniques for Evaluating the Esophagus

Chromoendoscopy

Electronic chromoendoscopy

Confocal laser endomicroscopy (CLE)

Volumetric laser endomicroscopy (VLE)

Summary

References

8 High‐Resolution Manometry and Esophageal Pressure Topography

Acknowledgments

Introduction

Indications for esophageal manometry

Manometry study technique and protocol

Interpretation of high‐resolution manometry and esophageal pressure topography

HRM/EPT beyond the Chicago classification

Conclusions

References

9 Esophageal Testing Using Multichannel Intraluminal Impedance

Introduction

Basic principles

High‐resolution impedance manometry

Esophageal function testing using combined multichannel intraluminal impedance and manometry

Multichannel intraluminal impedance for assessment of bolus transit in esophageal function tests

Combined MII‐EM in belching and rumination

Combined multichannel intraluminal impedance and pH for detection of acid and nonacid gastroesophageal reflux

References

10 Ambulatory Monitoring for Reflux

Introduction

Esophageal pH monitoring

Esophageal pH‐impedance monitoring

Esophageal bilirubin monitoring

Symptom association analysis

References

11 New Diagnostic Tests for GERD

Introduction

Bile monitoring

Novel impedance parameters

Salivary pepsin

Mucosal integrity

Oropharyngeal pH monitoring

Narrow‐band imaging

The road ahead

References

12 Role of Histology and Cytology in Esophageal Diseases

Introduction

Normal esophagus

Esophagitis

Esophageal Involvement in Systemic Disease

Esophageal manifestations of dermatologic and collagen vascular diseases

Gastroesophageal reflux esophagitis

Barrett’s esophagus

References

PART III: Motility Disorders

13 Achalasia

Definition

Epidemiology

Pathophysiology

Clinical manifestations

Diagnosis

Treatment

What to do if symptoms reoccur following successful initial treatment

Esophagectomy for end‐stage achalasia

Prognosis

To screen or not for esophageal cancer?

Guidelines

References

14 Non‐Achalasia Esophageal Motility Abnormalities

Introduction

Disorders with esophagogastric junction outflow obstruction other than achalasia

Major disorders of peristalsis

Minor disorders of peristalsis

Conclusions and future directions

References

15 Surgery for Esophageal Motor Disorders:

Introduction

Achalasia

Esophagogastric junction outflow obstruction

Distal esophageal spasm

Jackhammer esophagus

Conclusion

References

16 Esophageal Webs and Rings

Definitions

Proximal esophageal webs

Plummer‐Vinson syndrome

Lower esophageal rings

Schatzki’s ring

References

17 Esophageal Diverticula

Classification

Epidemiology

Anatomy

Pathophysiology

Complications

Physical examination

Diagnostic studies

Surgical management

Post‐operative management

References

18 Esophageal Involvement in Systemic Diseases

Introduction

Connective tissue disorders

Endocrine disorders

Genetic syndromes

Infiltrative disorders

Inflammatory disorders

Neuromuscular disorders

Conclusion

References

PART IV: Gastroesophageal Reflux Disease

19 Clinical Spectrum and Diagnosis of GERD Phenotypes

Introduction

The current paradigm of gastroesophageal reflux disease

Clinical spectrum of GERD

Further esophageal physiologic testing

Conclusion

References

20 Hiatus Hernia and Gastroesophageal Reflux Disease

Introduction

Anatomy of the diaphragm and the esophagogastric junction

Physiology of the esophagogastric junction

Hiatus hernia

Congenital diaphragmatic hernias

Sliding hiatus hernia and reflux disease

Diagnosis

Therapy

Conclusions

References

21 Pathophysiology of Gastroesophageal Reflux Disease: Motility Factors

Introduction

Sphincter mechanism at the esophagogastric junction (EGJ)

Gastroesophageal junction pressure under various physiologic conditions

Mechanisms of gastroesophageal reflux

Hiatus hernia and reflux disease

Compliance/opening function of LES and EGJ in GER disease

Role of esophageal peristalsis in reflux disease

Conclusions

References

22 Pathophysiology of Gastroesophageal Reflux Disease: Epithelial Factors

Introduction

Acid, pepsin, and bile acids: the epithelial triple threat

Development of the esophagus and its defensive players

Esophageal tissue resistance: epithelial factors and beyond

Assessing the epithelial barrier: measurements of resistance, permeability, and intercellular spaces

Pathophysiology of GERD and reflux esophagitis: acid burn or cytokine sizzle?

Conclusions and future directions

References

23 Duodenogastroesophageal Reflux

Introduction

The role of acid and pepsin

The role of duodenal contents

Detection of DGER in humans

Medical and surgical treatment

Conclusion

References

24 Helicobacter pylori and GERD

Introduction

Epidemiology of

H. pylori

and GERD

Pathobiology of

H. pylori

and GERD

Implication of eradication of

H. pylori

on de novo GERD

Implication of

H. pylori

eradication on patients with known GERD

H. pylori

and Barrett’s esophagus

H. pylori

and esophageal adenocarcinoma and gastroesophageal junction adenocarcinoma

Professional guidelines, recommendations, and updates

Conclusions

References

25 Medical Management of Gastroesophageal Reflux Disease

Introduction

Lifestyle modifications

Pharmacologic therapy

Long‐term management

References

26 Refractory Heartburn: Reflux Hypersensitivity and Functional Heartburn

Introduction

Functional heartburn

Reflux hypersensitivity

Overlap with GERD

References

27 Endoscopic Therapies for GERD

Introduction

Understanding GEJ anatomy and physiology

Radiofrequency energy treatment of GERD (Stretta)

Trans‐oral incisionless fundoplication (TIF)

Endoscopic suturing for GERD

Conclusions

References

28 Behavioral Treatment of Oropharyngeal and Esophageal Disorders

Dysphagia

Aerophagia

Supragastric belching

Rumination

Extraesophageal reflux

Disorders of laryngeal hyper‐responsiveness

Summary

References

29 Barrett’s Esophagus

Introduction

Definition and diagnostic criteria

Epidemiology

Pathogenesis and progression

Clinical Presentation

Management

Treatment

Challenges In Management

References

30 Esophageal Strictures

Classification of strictures

Types of esophageal dilators

Techniques of esophageal dilation

Simple strictures

Complex strictures

Radiation‐induced strictures

Steroid injections

Incisional therapy

Temporary stents

Mitomycin C

Self dilation

Conclusions

References

31 ENT Complaints in GERD

Introduction

Prevalence

Pathophysiology

Diagnosis

Laryngoscopy

Confirmatory testing for EER/LPR

Endoscopy

Management

Surgical therapy

Cost

Conclusion

References

32 Pulmonary Complications of Gastroesophageal Reflux Disease

Introduction

Pathophysiology

Clinical presentations and evaluation

Therapy

Asthma and GERD

Pulmonary fibrosis and GERD

GERD and lung transplant

Conclusions

References

33 Pediatric Gastroesophageal Reflux Disease

Gastroesophageal reflux

Diagnostic evaluation

Treatment

Pharmacologic therapy

Surgical Therapy

Conclusion

References

34 Challenges in the Understanding and Application of Antireflux Surgery for GERD

Historical overview

Fundoplications

Longevity of antireflux surgery

Antireflux surgery and Barrett’s esophagus

Conclusions

References

35 New Surgical Treatments for GERD

Introduction

Magnetic sphincter augmentation (MSA) of the lower esophageal sphincter

Current approach to patient selection and perioperative management

Lower esophageal sphincter (LES) electrical neuromodulation therapy (LES‐ENT)

References

36 Obesity and Gastroesophageal Reflux Disease

Introduction

Obesity and GERD symptoms

Obesity and GERD‐related complications

Mechanical and non‐mechanical effects of obesity

Weight loss as GERD treatment

Conclusion

References

PART V: Malignant Disease

37 Tumors of the Esophagus

Introduction

Malignant esophageal cancers

Conclusions

Benign tumors of the esophagus

Conclusions

References

38 Endoscopic Treatment of Esophageal Cancer

Rationale for the endoscopic treatment of esophageal cancer

Methods used in the endoscopic treatment of esophageal carcinoma

Ablation techniques

Adjuvant chemotherapy and radiation therapy

Outcomes of endoscopic treatment of early esophageal cancer

References

39 Surgical Treatment for Esophageal Cancer

Introduction

Diagnosis and screening

Staging

Preoperative assessment of physiological status

Surgical therapy

Neo‐adjuvant therapy

Pragmatic therapeutic strategy

Conclusions

Acknowledgment

References

PART VI: Miscellaneous

40 Eosinophilic Esophagitis

Financial support

Introduction

Epidemiology

Diagnosis

Clinical features

Histology

Pathogenesis

Natural history

Treatment

Conclusion

References

41 Foreign Bodies

Introduction

Anatomical considerations

Clinical presentation

Diagnostic evaluation

Management

Food impactions

Sharp or pointed objects

Batteries

Magnets

Small, blunt, round objects

Coins

Other objects

Dishwasher or laundry pods

Narcotic packages

Management of complications

References

42 Medication‐Induced Esophageal Injury

Introduction

Mechanisms

Pathology

Clinical features and diagnosis

Prevention, treatment, and clinical course

Specific medications

References

43 Esophagitis in the Immunocompromised Host

Introduction

Epidemiology

Predisposing factors

General considerations

Fungal infections

Viral infections

Mycobacterial infections

Bacterial infections

Treponema pallidum

Protozoal infections

Selected HIV‐related esophageal disorders

References

44 Caustic Injuries of the Esophagus

Introduction

Incidence

Pathophysiology

Acid‐induced injury

Determinants of severity

Clinical presentation

Initial evaluation

Management

Management of late complications

Esophageal cancer

Conclusion

References

45 Rupture and Perforation of the Esophagus

Introduction

Pathophysiology

Boerhaave syndrome

Esophageal obstruction

Ingestions

Trauma

Iatrogenic perforation

Clinical features and diagnosis

Approach to management

Surgical management

Endoscopic management

Stent placement

Prognosis

Summary

References

46 Cutaneous Diseases of the Esophagus

Introduction

Inflammatory mucocutaneous disorders of the skin and mucous membranes including the esophagus

Multisystem disorders that have both mucocutaneous and esophageal manifestations

References

47 Esophageal Disease in Older Patients

Introduction

Changes in esophageal physiology with aging

Changes in gastroesophageal reflux disease‐related physiology with aging

Differences in treatment of older patients

Dysphagia

Central nervous system diseases

Idiopathic upper esophageal sphincter dysfunction

Local structural lesions

Zenker’s diverticulum

General approach to oropharyngeal dysphagia

Esophageal dysphagia

Achalasia

Distal esophageal spasm and related disorders

Esophagogastric junction outflow obstruction (EGJO)

Jackhammer esophagus

Scleroderma

Esophageal cancer

Peptic stricture

Rings and webs

Vascular compression

Medication‐induced esophageal injury

Miscellaneous conditions

Conclusions

References

Index

End User License Agreement

List of Tables

Chapter 1

Table 1.1 Most common symptoms attributed to the esophagus.

Table 1.2 Etiologies of oropharyngeal dysphagia.

Table 1.3 Etiologies of esophageal dysphagia.

Table 1.4 Common etiologies of pill esophagitis.

Table 1.5 Diagnostic criteria for globus.

Table 1.6 Available assessment tools for patients with GERD.

Chapter 3

Table 3.1 Symptoms/signs of oropharyngeal dysphagia.

Table 3.2 Causes of oropharyngeal dysphagia.

Table 3.3 Postural techniques and swallowing maneuvers and exercises.

Chapter 4

Table 4.1 Rome IV criteria of rumination syndrome.

Table 4.2 Differential diagnosis and contrasting features of rumination syndr...

Table 4.3 Treatment of rumination syndrome.

Chapter 5

Table 5.1 Effects of hormones and putative neurotransmitters on the lower eso...

Chapter 8

Table 8.1 Normal values by HRM assembly manufacturer. Values reflect 5 ml liq...

Table 8.2 Summary of publications describing achalasia outcomes by HRM achala...

Table 8.3 Summary of adjunctive and provocative maneuvers used in clinical ma...

Chapter 9

Table 9.1 Normative data of impedance (MII) parameters of esophageal function...

Table 9.2 Normative data for reflux using combined impedance‐pH monitoring.

Chapter 10

Table 10.1 Main symptom correlation indices used in esophageal reflux testing...

Table 10.2 Interpretation of esophageal test results according to the Lyon Co...

Chapter 11

Table 11.1 Advantages and disadvantages of novel diagnostic tests for GERD.

Chapter 14

Table 14.1 Summary of the Chicago Classification scheme for esophageal motili...

Table 14.2 Anatomic etiologies associated with the manometric diagnosis of EG...

Table 14.3 Conditions associated with IEM.

Chapter 15

Table 15.1 The Eckart severity score. The final score is the sum of the four ...

Chapter 16

Table 16.1 Conditions associated with upper esophageal webs.

Table 16.2 Options for endoscopic treatment of esophageal webs and rings.

Chapter 19

Table 19.1 Evaluation step 1: clinical history.

Table 19.2 Evaluation step 2: upper GI endoscopy.

Table 19.3 Evaluation step 3: ambulatory reflux monitoring.

Table 19.4 Questions addressed by esophageal manometry.

Table 19.5 Questions addressed by impedance‐pH monitoring.

Chapter 22

Table 22.1 Histologic findings and confocal laser endomicroscopy measurements...

Chapter 24

Table 24.1 Professional guidelines recommendations regarding GERD and

H. pylor

...

Chapter 25

Table 25.1 Effects of foods and other substances on GERD symptoms.

Table 25.2 Recommendations based on results of a review of studies involving ...

Table 25.3 Hierarchy of intragastric pH control.

Table 25.4 PPI adverse events.

Chapter 26

Table 26.1 Rome IV functional esophageal disorders.

Table 26.2 Diagnostic criteria

a

for functional heartburn (Rome IV).

Table 26.3 Clinical characteristics of patients with functional heartburn.

Table 26.4 Therapeutic options for patients with functional heartburn.

Table 26.5 Diagnostic criteria for reflux hypersensitivity (Rome IV).

Table 26.6 Therapeutic options for patients with reflux hypersensitivity.

Chapter 28

Table 28.1 Robust Esophageal Sweep Test (REST) protocol. Evaluate each bolus ...

Table 28.2 Operational definitions for the REST protocol.

Chapter 29

Table 29.1 Proposed risk factors and protective factors for Barrett’s esophag...

Chapter 30

Table 30.1 Common etiologies of benign strictures.

Table 30.2 Tips for esophageal dilation.

Chapter 31

Table 31.1 Differential diagnosis of laryngopharyngeal reflux.

Table 31.2 Reflux finding score.

Table 31.3 Reflux symptom index.

Chapter 32

Table 32.1 Pulmonary conditions associated with erosive esophagitis and/or es...

Chapter 33

Table 33.1 Medications and doses used in children.

Chapter 35

Table 35.1 Normalization of esophageal acid exposure post LINX based on the t...

Table 35.2 Size of LINX implants by year for the US combined registry series ...

Table 35.3

Diameters and bead separation with a 15 mm balloon

Table 35.4

Esophageal acid exposure pre and post MSA.

Table 35.5 Erosion rate by device size.

Chapter 37

Table 37.1 Risk factors for esophageal cancer by histologic subtype.

Table 37.2 Subclassification of T1 esophageal cancers.

Table 37.3 Common benign esophageal tumors.

Chapter 38

Table 38.1 Prevalence of lymph node metastases in different tumor (T) stages ...

Chapter 40

Table 40.1 Diagnostic criteria for eosinophilic esophagitis.

Table 40.2 Diseases associated with esophageal eosinophilia.

Table 40.3 Histopathologic features of eosinophilic esophagitis.

Table 40.4 Instructions on topical steroid use.

Table 40.5 Clinical considerations for esophageal dilation in eosinophilic es...

Chapter 42

Table 42.1 Medications commonly associated with esophagitis or esophageal inj...

Chapter 43

Table 43.1 Reported etiologies of esophageal infections.

Table 43.2 Presentations and complications of esophageal infections.

Table 43.3 Pathologic findings of esophageal candidiasis infections.

Table 43.4 Recommended treatment regimens for esophageal infections.

Chapter 44

Table 44.1 Examples of commonly ingested caustic/corrosive agents.

Table 44.2 Common medications associated with esophageal injury. NSAIDs, non‐...

Table 44.3 Signs and symptoms of caustic ingestion.

Chapter 45

Table 45.1 Etiologies for esophageal rupture and perforation.

Table 45.2

Estimated risk of perforation from endoscopic procedures.

Table 45.3 Diagnosis of esophageal perforation.

Table 45.4 Approach to management.

Table 45.5 Endoscopic tools and adjuncts for management of esophageal perfora...

Chapter 46

Table 46.1 Esophageal diseases with cutaneous findings.

Table 46.2 Genodermatoses with associated esophageal manifestations.

Chapter 47

Table 47.1 Causes of oropharyngeal dysphagia in older patients.

Table 47.2 Esophageal causes of dysphagia in older patients.

Table 47.3 Common medications producing dysphagia in older patients.

List of Illustrations

Chapter 1

Figure 1.1 Algorithm for the evaluation of dysphagia.

Chapter 2

Figure 2.1 Diagnostic and treatment algorithm for esophageal chest pain.

Figure 2.2 Mechanisms of esophageal injury and peripheral and central sensit...

Chapter 3

Figure 3.1 Still frames of deglutitive vocal cord closure seen by (A) transn...

Figure 3.2 Sequence of events during primary swallows. (A–D) The primary swa...

Figure 3.3 Relationship of deglutitive vocal cord kinetics to other events o...

Chapter 4

Figure 4.1 Manometric pattern of rumination syndrome. Arrow indicates period...

Figure 4.2 Teaching diaphragmatic breathing.

Chapter 5

Figure 5.1 Central control of the oropharynx and esophagus. The oropharyngea...

Figure 5.2 Excitation and inhibition in the swallowing network. (A) The swal...

Figure 5.3 Muscular activity during the pharyngeal stage. A schematic view o...

Figure 5.4 Volume‐induced (1 and 20 mL) modification of timing of events dur...

Figure 5.5 Normal oropharyngeal swallow. (A) At rest the bolus is held in th...

Figure 5.6 Upper esophageal function by high‐resolution manometry. The left ...

Figure 5.7 Three‐dimensional pressure profile of the upper esophageal sphinc...

Figure 5.8 Muscular architecture of the pharynx and upper esophagus from the...

Figure 5.9 Velocity of the peristaltic wave front along the esophagus. The b...

Figure 5.10 Esophageal peristalsis: relationship between videofluoroscopic, ...

Figure 5.11 Vagus nerve firing patterns with esophageal peristalsis. The fir...

Figure 5.12 Difference in the duration of the inhibitory junction potential ...

Figure 5.13 Interplay of cholinergic (ACh) and non‐cholinergic (NANC) influe...

Figure 5.14 Anatomy of the diaphragmatic hiatus: the right crus encircling t...

Figure 5.15 Lower esophageal sphincter (LES) radial muscle thickness and 3D ...

Figure 5.16 Reflex arc underlying transient lower esophageal sphincter relax...

Chapter 6

Figure 6.1 Normal pharynx. (A) Frontal view of the pharynx. The surface of t...

Figure 6.2 Folds of the epiglottis in a patient with radiation change. (A) F...

Figure 6.3 Relationship of the laryngeal cartilages to the pharynx. (A) Line...

Figure 6.4 Relationship of larynx to pharynx in a patient who has aspirated....

Figure 6.5 Postcricoid squamous mucosa. Just posterior to the cricoid cartil...

Figure 6.6 Representative frames from the pharyngeal phase of swallowing. (A...

Figure 6.7 Laryngeal penetration. (A) During drinking, barium enters the lar...

Figure 6.8 Asymmetric epiglottic tilt. There is diminished epiglottic tilt o...

Figure 6.9 Overflow aspiration. This man had global pharyngeal weakness due ...

Figure 6.10 Zenker’s diverticulum. (A) Frontal view of the pharynx demonstra...

Figure 6.11 Pharyngeal regurgitation from Zenker’s diverticulum. (A) Frontal...

Figure 6.12 Pseudo‐Zenker’s diverticulum. (A) Lateral view of the pharynx du...

Figure 6.13 Incomplete opening of the cricopharyngeus. (A) Lateral view of t...

Figure 6.14 Extrinsic impressions during passage of bolus through the pharyn...

Figure 6.15 Killian–Jamieson diverticula. (A) Frontal view of the pharynx de...

Figure 6.16 Synchronous Zenker’s and Killian–Jamieson diverticula. Oblique v...

Figure 6.17 Lateral pharyngeal pouches. (A) Line drawing of the pharynx in l...

Figure 6.18 Lateral pharyngeal diverticulum. A 0.8 cm barium‐filled sac (arr...

Figure 6.19 Branchial pouch sinus. (A) Frontal view of the pharynx shows an ...

Figure 6.20

Candida

pharyngitis. Innumerable nodules and plaque‐like elevati...

Figure 6.21 Scarring from corrosive ingestion. Lateral view of the pharynx s...

Figure 6.22 Lymphoid hyperplasia of the palatine tonsils and tongue base. (A...

Figure 6.23 Lymphoid hyperplasia of the tongue base. Barium fills the groove...

Figure 6.24 Cervical esophageal web. (A) Frontal and (B) lateral views demon...

Figure 6.25 Retention cyst in medial left hypopharynx. A smooth‐surfaced hem...

Figure 6.26 Polypoid squamous cell carcinoma of the base of the tongue. (A) ...

Figure 6.27 Infiltrative squamous cell carcinoma of right aryepiglottic fold...

Figure 6.28 Ulcerative squamous cell carcinoma of the epiglottis. (A) Latera...

Figure 6.29 Polypoid squamous cell carcinoma of the right piriform sinus. (A...

Figure 6.30 Plaque‐like squamous cell carcinoma of the posterolateral pharyn...

Figure 6.31 Ulcerated squamous cell carcinoma of the pharyngoesophageal segm...

Figure 6.32 Lymphoma of the palatine tonsil. Lateral view of the pharynx aft...

Figure 6.33 Lymphoma of the base of the tongue. Lateral view of the pharynx ...

Figure 6.34 Diffuse radiation changes. (A) Frontal view of the pharynx shows...

Figure 6.35 Normal esophagus and cardia. (A) Double‐contrast view of the eso...

Figure 6.36 Reflex esophagitis with granular mucosa. Double‐contrast view sh...

Figure 6.37 Reflux esophagitis with ulceration. (A) Double‐contrast view sho...

Figure 6.38 Reflux esophagitis with thickened folds. Double‐contrast view sh...

Figure 6.39 Reflux esophagitis with inflammatory esophagogastric polyp. Pron...

Figure 6.40 Scarring of distal esophagus with fixed transverse folds. Double...

Figure 6.41 Peptic stricture. Double‐contrast view shows a smooth, tapered a...

Figure 6.42 Feline esophagus. Double‐contrast view shows delicate transverse...

Figure 6.43 Barrett’s esophagus with mid‐esophageal stricture. Prone single‐...

Figure 6.44 Barrett’s esophagus with reticular pattern. Double‐contrast view...

Figure 6.45

Candida

esophagitis with plaques. Double‐contrast view shows mul...

Figure 6.46 Advanced

Candida

esophagitis with “shaggy” esophagus. Double‐con...

Figure 6.47 Herpes esophagitis. Double‐contrast view shows multiple tiny ulc...

Figure 6.48 Herpes esophagitis in an otherwise healthy patient. Double‐contr...

Figure 6.49 Cytomegalovirus (CMV) esophagitis in an acquired immunodeficienc...

Figure 6.50 Human immunodeficiency virus (HIV) esophagitis in patients with ...

Figure 6.51 Drug‐induced esophagitis. Double‐contrast view shows several sma...

Figure 6.52 Drug‐induced stricture. Double‐contrast view shows a smooth, tap...

Figure 6.53 Eosinophilic esophagitis with a “ringed esophagus.” Double‐contr...

Figure 6.54 Eosinophilic esophagitis with a small‐caliber esophagus. Prone s...

Figure 6.55 Lichen planus with a small‐caliber esophagus. Prone single‐contr...

Figure 6.56 Radiation injury to the esophagus. (A) Double‐contrast view show...

Figure 6.57 Chronic lye stricture. Double‐contrast view shows a long strictu...

Figure 6.58 Squamous papilloma. Single‐contrast view shows a small, lobulate...

Figure 6.59 Glycogenic acanthosis. Double‐contrast view shows multiple small...

Figure 6.60 Leiomyoma. Double‐contrast view shows a submucosal mass (arrows)...

Figure 6.61 Giant fibrovascular polyp. (A) Double‐contrast view shows a smoo...

Figure 6.62 Communicating esophageal duplication cyst. Single‐contrast view ...

Figure 6.63 Early esophageal carcinoma. Double‐contrast view shows a plaque‐...

Figure 6.64 Early adenocarcinoma in Barrett’s esophagus. Double‐contrast vie...

Figure 6.65 Superficial spreading carcinoma. Double‐contrast view shows foca...

Figure 6.66 Infiltrating squamous cell carcinoma. Double‐contrast view shows...

Figure 6.67 Polypoid squamous cell carcinoma. Double‐contrast view shows a p...

Figure 6.68 Primary ulcerative squamous cell carcinoma. Double‐contrast view...

Figure 6.69 Infiltrating adenocarcinoma. Double‐contrast view shows an irreg...

Figure 6.70 Schatzki ring. (A) Double‐contrast view shows no evidence of a r...

Figure 6.71 Giant epiphrenic diverticulum. Single‐contrast view shows a larg...

Figure 6.72 Traction diverticulum. Double‐contrast view shows a triangular o...

Figure 6.73 Esophageal intramural pseudodiverticulosis. (A) Double‐contrast ...

Figure 6.74 Primary achalasia. Single‐contrast esophagram shows a markedly d...

Figure 6.75 Secondary achalasia caused by bronchogenic carcinoma. Double‐con...

Figure 6.76 Diffuse esophageal spasm. (A) Prone single‐contrast view shows m...

Figure 6.77 Esophageal varices. Single‐contrast view shows multiple large se...

Figure 6.78 Esophageal food impaction. (A) On the initial barium study, an i...

Figure 6.79 Esophageal carcinoma with esophagobronchial fistula. A barium st...

Figure 6.80 Esophageal perforation after traumatic endoscopy. A study with a...

Chapter 7

Figure 7.1 VLE Barrett’s esophagus case 1: 63‐year‐old with random surveilla...

Figure 7.2 VLE Barrett’s esophagus case 2: 70‐year‐old with random surveilla...

Figure 7.3 VLE Barrett’s esophagus case 3: 60‐year‐old with random surveilla...

Chapter 8

Figure 8.1 Esophagogastric junction (EGJ) morphology. Morphology of the EGJ ...

Figure 8.2 Esophageal pressure topography metrics. (A) An example of a norma...

Figure 8.3 Stepwise classification of individual swallows on HRM/EPT. Applic...

Figure 8.4 Swallow types of HRM/EPT. (A) Premature swallow; the distal laten...

Figure 8.5 The Chicago Classification of esophageal motility diagnoses [4]. ...

Figure 8.6 Achalasia subtypes. All three subtypes are characterized by eleva...

Figure 8.7 Rumination and supragastric belching. Examples: a rumination even...

Figure 8.8 Multiple rapid swallows (MRS) and rapid drink challenge (RDC). Ex...

Chapter 9

Figure 9.1 Impedance changes observed during bolus transit over a single pai...

Figure 9.2 Multiple impedance measuring segments within the esophagus allow ...

Figure 9.3 Movement of intraesophageal material detected by multichannel int...

Figure 9.4 HRiM recording. Impedance data is shown as a color‐contour mode (...

Figure 9.5 Nine‐channel combined multichannel intraluminal impedance (MII) a...

Figure 9.6 Definitions of impedance parameters. (A) Total bolus transit time...

Figure 9.7 Classification of swallows by multichannel intraluminal impedance...

Figure 9.8 Percentage of patients with complete bolus transit in 350 patient...

Figure 9.9 Example of rumination on HRIM. Length of the esophagus is shown a...

Figure 9.10 Schematic representation of the 2 mm diameter multichannel intra...

Figure 9.11 Impedance changes in ohms during three episodes of reflux. The s...

Figure 9.12 Impedance changes in ohms during reflux of gas, liquid, and mixe...

Figure 9.13 Novel MI balloon catheter with 36 channels measuring impedance a...

Chapter 10

Figure 10.1 Esophageal pH monitoring electrodes. (A) Catheter with antimony ...

Figure 10.2 Example of 24‐hour esophageal pH monitoring in a patient with he...

Figure 10.3 Example of 48‐hour wireless pH monitoring showing multiple and p...

Figure 10.4 Example of normal 96‐hour wireless pH monitoring.

Figure 10.5 Example of a pH‐impedance catheter equipped with six pairs of im...

Figure 10.6 Combined impedance‐pH recordings showing examples of the three t...

Figure 10.7 GERD phenotypes according to endoscopy and ambulatory reflux mon...

Chapter 11

Figure 11.1 Novel mucosal integrity (MI) balloon catheter with two strips of...

Figure 11.2 (A) Schematic of mucosal integrity prototype catheter advanced v...

Figure 11.3 (A) Oropharyngeal pH probe (Dx‐pH Measurement System) with LED t...

Chapter 12

Figure 12.1 (A) Normal esophageal squamous mucosa with a thin basal epitheli...

Figure 12.2 Normal esophageal brushing composed predominantly of mature squa...

Figure 12.3

Candida

esophagitis. Pseudohyphal and yeast organisms are identi...

Figure 12.4 Esophageal brush cytology specimen with squamous epithelial cell...

Figure 12.5 Herpes esophagitis. Squamous epithelial cells with ground‐glass ...

Figure 12.6 Esophageal brush cytology specimen showing multinucleation, mold...

Figure 12.7 Cytomegalovirus (CMV) esophagitis. In the center of the field, t...

Figure 12.8 Esophageal brush cytology specimen showing a markedly enlarged c...

Figure 12.9 Atypical squamous epithelial cells following radiation therapy. ...

Figure 12.10 Esophagitis dissecans superficialis caused by alendronate. (A) ...

Figure 12.11 Primary eosinophilic esophagitis characterized by numerous intr...

Figure 12.12 Esophageal involvement by lichen planus. (A) Parakeratosis, int...

Figure 12.13 Early morphologic features in gastroesophageal reflux disease (...

Figure 12.14 Intraepithelial eosinophilia in a patient with gastroesophageal...

Figure 12.15 Intraepithelial neutrophils in a patient with gastroesophageal ...

Figure 12.16 Lymphocytic esophagitis in a patient with gastroesophageal refl...

Figure 12.17 Epithelial repair characterized by cohesive epithelial cells ar...

Figure 12.18 Low‐magnification view of Barrett’s esophagus. Goblet cells are...

Figure 12.19 Higher‐magnification view of Barrett’s esophagus, characterized...

Figure 12.20 Barrett’s esophagus with complete intestinal metaplasia. The Al...

Figure 12.21 Alcian blue and periodic acid‐Schiff (PAS) stain highlighting i...

Figure 12.22 Atrophic cardiac‐type mucosa in a biopsy obtained from this dis...

Figure 12.23 Non‐dysplastic Barrett’s esophagus. The base of the mucosa show...

Figure 12.24 Barrett’s esophagus with low‐grade dysplasia. The glands show n...

Figure 12.25 High‐grade dysplasia in Barrett’s esophagus. There is marked cy...

Figure 12.26 Intramucosal adenocarcinoma arising in Barrett’s esophagus. The...

Figure 12.27 Brush cytology specimen of Barrett’s esophagus with high‐grade ...

Figure 12.28 Adenocarcinoma arising in Barrett’s esophagus, characterized by...

Figure 12.29 Superficially invasive esophageal squamous cell carcinoma. Smal...

Figure 12.30 Esophageal carcinoma cuniculatum is characterized by deeply inv...

Figure 12.31 Well‐differentiated squamous cell carcinoma. Spindle‐shaped mal...

Figure 12.32 Brush cytology specimen of a poorly differentiated squamous cel...

Figure 12.33 Esophageal small cell carcinoma. At low magnification, the cell...

Figure 12.34 High‐magnification view of an esophageal small cell carcinoma. ...

Figure 12.35 High‐magnification view of an esophageal melanoma. The tumor is...

Chapter 13

Figure 13.1 Schematic representation of the pathogenesis of achalasia.

Figure 13.2 Manometric subtypes of achalasia.

Figure 13.3 Typical radiological image of bird beak (A) and end‐stage “sigmo...

Figure 13.4 CT scan of a patient with achalasia. The dilated esophagus fille...

Figure 13.5 Pneumatic dilation is performed using a Rigiflex balloon (A) pos...

Figure 13.6 Schematic representation of laparoscopic Heller myotomy showing ...

Figure 13.7 Long‐term success rates of the European Achalasia Trial comparin...

Figure 13.8 Schematic representation of the different steps of the POEM proc...

Chapter 14

Figure 14.1 A swallow in a patient with idiopathic EGJOO on HRM. There is an...

Figure 14.2 An abnormal timed barium esophagram in a patient with idiopathic...

Figure 14.3 A suggested diagnostic and treatment algorithm for patients with...

Figure 14.4 A swallow and abnormal motility in the esophageal body in a pati...

Figure 14.5 A swallow with abnormal esophageal smooth muscle hypercontractil...

Figure 14.6 A swallow with esophageal smooth muscle hypocontractility on HRM...

Figure 14.7 A swallow on HRM demonstrating a large break (> 5cm) in the 20 m...

Chapter 15

Figure 15.1 The functional lumen imaging probe balloon catheter (Endoflip®) ...

Figure 15.2 (A) Mucosectomy overlying submucosal bleb; (B) submucosal tunnel...

Figure 15.3 Laparoscopic approach to begin the dissection for a LHM. The hep...

Figure 15.4 Intraoperative laparoscopic view of the creation of the anterior...

Figure 15.5 Before and after images of a laparoscopic Heller myotomy with Do...

Figure 15.6 Intraoperative laparoscopic view of a Heller myotomy with Toupet...

Figure 15.7 Completed Dor fundoplication.

Figure 15.8 Barium esophagram showing the classic corkscrew appearance of DE...

Chapter 16

Figure 16.1 Double‐contrast esophagram of an upper esophageal web (arrow)....

Figure 16.2 Diagram of lower esophageal rings: A, B (Schatzki), and C rings ...

Figure 16.3 Chart showing the relationship between dysphagia and the diamete...

Figure 16.4 (A) Double‐contrast esophagram. (B) Antegrade endoscopic view....

Chapter 17

Figure 17.1 Anatomic relationship of Zenker’s diverticulum vs. Killian‐Jamie...

Figure 17.2 Anatomic location of the three major types of esophageal diverti...

Figure 17.3 Contrast esophagogram of (A) Killian‐Jamieson diverticulum; (B) ...

Figure 17.4 Intraoperative photo of Zenker’s diverticulum during open resect...

Figure 17.5 Intraoperative images demonstrating the use of the endoscope to ...

Figure 17.6 Intraoperative image of laparoscopic excision of epiphrenic dive...

Figure 17.7 Intraoperative image depicting (A) staple line; (B) exposed esop...

Chapter 18

Figure 18.1 Scleroderma can present with a myriad of esophageal endoscopic p...

Figure 18.2 While the vast majority of SSc patients have esophageal involvem...

Figure 18.3 The esophagus in a 63‐year‐old man with dysphagia in the context...

Figure 18.4 (A) and (B) The esophagus of a 67‐year‐old woman with Crohn’s di...

Chapter 19

Figure 19.1 Time trends of estimated prevalence of GERD in the United States...

Figure 19.2 Stepwise diagnostic approach to phenotyping GERD. Step 1 is the ...

Figure 19.3 Clinical assessment of symptoms (step 1). According to the Montr...

Figure 19.4 Upper GI endoscopic evaluation for GERD (step 2). In GERD, the o...

Figure 19.5 Applications of esophageal manometry in GERD. (A) Example of mul...

Chapter 20

Figure 20.1 Inferior view on the diaphragm. Openings are visible for the ven...

Figure 20.2 Relationship between the esophagus and lower esophageal sphincte...

Figure 20.3 Results of an ambulatory 24‐hour monitoring study showing that t...

Figure 20.4 Barium esophagogram showing a partially intrathoracic stomach wi...

Figure 20.5 Endoscopic image of a sliding hiatus hernia. A small erosion is ...

Figure 20.6 Endoscopic image of a sliding hiatus hernia with a Schatzki ring...

Figure 20.7 Plain upright chest radiograph of a patient with a very large sl...

Figure 20.8 Plain upright chest radiograph showing a retrocardiac air–fluid ...

Figure 20.9 Coronal reconstruction of the gastroesophageal junction, scanned...

Chapter 21

Figure 21.1 Myoarchitecture of the lower esophageal Sphincter.

Figure 21.2 Myoarchitecture of the esophageal hiatus formed by the right and...

Figure 21.3 Myoarchitecture of the esophageal hiatus formed by the right and...

Figure 21.4 3D pressure topography of the esophagogastric junction (EGJ). Me...

Figure 21.5 Transient lower esophageal sphincter relaxation (TLSER) recorded...

Figure 21.6 Patterns of longitudinal muscle contraction of the esophagus dur...

Figure 21.7 Neural pathway to the lower esophageal sphincter (LES) and crura...

Figure 21.8 Proposed sites of action of pharmacologic agents targeting trans...

Chapter 22

Figure 22.1 Esophageal mucosa and submucosa. Photomicrograph showing the his...

Figure 22.2 Epithelial defense: structural components. (A) In humans, epithe...

Figure 22.3 Transmission electron micrograph at 50,000X magnification showin...

Figure 22.4 Immunostaining for the tight junction protein occludin in the hu...

Figure 22.5 Epithelial defense: functional components. Functional components...

Figure 22.6 Photomicrographs of the distal esophagus in rats after the surgi...

Figure 22.7 Representative images of the distal esophagus from a single pati...

Chapter 23

Figure 23.1 Time to onset of pain is related to the pH of the infused soluti...

Figure 23.2 Proposed agents responsible for esophageal mucosal injury. Mucos...

Figure 23.3 Cell proliferation under different pH conditions: (A) no acid; (...

Figure 23.4 Transmission electron micrographs of rabbit esophageal mucosa. (...

Figure 23.5 Relationship between percentage of time that bilirubin absorbanc...

Figure 23.6 Laboratory spectrophotometric absorbance for bilirubin ditaurate...

Figure 23.7 A typical pH‐Bilitec recording. The upper tracing from pH‐metry ...

Figure 23.8 Relationship between percent of time that bilirubin absorbance i...

Figure 23.9 Group median (A) acid reflux and (B) DGER for five study populat...

Figure 23.10 Acid exposure and DGER in 65 patients with typical reflux sympt...

Figure 23.11 Gastroesophageal reflux is detected by impedance and defined by...

Figure 23.12 Simultaneous impedance‐pH‐Bilitec recordings. Esophageal biliru...

Figure 23.13 Reflux‐associated symptom episodes in 72 patients: 165 symptom ...

Figure 23.14 Omeprazole 20 mg bid markedly decreased both acid and DGER.

Figure 23.15 A) Combined pH and Bilitec monitoring in a patient with typical...

Chapter 24

Figure 24.1 Trends in esophageal diseases related to

H. pylori

in developed ...

Figure 24.2 Gastritis patterns in infection affect gastric acid secretion. A...

Figure 24.3 Incidence of reflux esophagitis in patients with duodenal ulcer ...

Figure 24.4 The Houston Consensus Conference suggests that patients receivin...

Chapter 25

Figure 25.1 Study showing a clear relationship between increase in body mass...

Figure 25.2 Healing of erosive esophagitis at 8 weeks with various delayed‐r...

Figure 25.3 Symptom relief after 4 weeks of daily therapy on once‐daily prot...

Chapter 26

Figure 26.1 The evolution of diagnosing nonerosive reflux disease(NERD), fun...

Figure 26.2 Diagnostic algorithm of patients with heartburn with either prov...

Figure 26.3 Percentage of functional heartburn and reflux hypersensitivity p...

Figure 26.4 Underlying mechanism for esophageal hypersensitivity.

Figure 26.5 (A) Immunohistochemical nerve fiber identification with in the p...

Figure 26.6 New metrics to separate between functional esophageal disorders ...

Figure 26.7 Diagnostic algorithm of functional heartburn and reflux hypersen...

Figure 26.8 Distribution of functional esophageal disorders, using Rome IV c...

Chapter 27

Figure 27.1 Spectrum of anatomical defects among patients with gastroesophag...

Figure 27.2 Muscle fibers of the proximal stomach that make up the distal po...

Figure 27.3 Radiofrequency generator for the Stretta procedure.

Figure 27.4 Single‐use catheter for the Stretta procedure.

Figure 27.5 Muscle fibers of the proximal stomach that make up the distal po...

Figure 27.6 Endoscopic appearance after successful completion of the Stretta...

Figure 27.7 Applying the principles of anti‐reflux surgery to laparoscopic f...

Figure 27.8 Diagram and image of the muscle fibers in the distal esophagus (...

Figure 27.9 The “60 seconds rule” for assessing the diaphragmatic hiatus in ...

Figure 27.10 The goal of TIF 2.0 is to create full‐thickness serosa‐to‐seros...

Figure 27.11 The multiple parts and features of the EsophyX®‐Z+ device. (A) ...

Figure 27.12 The endoscope in position to provide light and visualization of...

Figure 27.13 Mapping of the TIF 2.0 protocol using standard landmarks for pl...

Figure 27.14 After completing three plications in the posterior corner, the ...

Figure 27.15 After completing three plications in the anterior corner, the d...

Figure 27.16 Mucosal ablation and suturing of the esophageal gastric junctio...

Figure 27.17 Resection and plication (RAP) technique for GERD in a patient a...

Figure 27.18 Summary diagram appropriating the various endoscopic anti‐reflu...

Chapter 28

Figure 28.1 Example of referred sensation from abnormality in the lower esop...

Figure 28.2 Esophageal abnormalities identified during MBS with esophageal s...

Figure 28.3 International Dysphagia Diet Standardization Initiative (IDDSI) ...

Figure 28.4 Endoscopic view of laryngopharynx (A) at rest with vocal folds a...

Figure 28.5 Air‐fluid column in stomach (A) disappears as patient belches (B...

Figure 28.6 Rumination observed on fluoroscopy evidenced by LES relaxation a...

Figure 28.7 Examples of radiographic findings on MBS related to GERD: (A) cr...

Figure 28.8 Common pathologies thought to be related to reflux include (A) v...

Figure 28.9 Normal vocal fold abduction (A), Paradoxical vocal fold closure ...

Chapter 29

Figure 29.1 Long‐segment Barrett’s with utilization of the Prague Classifica...

Figure 29.2 (A) Image of low‐grade dysplasia with maintenance of mucosal arc...

Figure 29.3 Diagrammatic representation of endoscopic Barrett’s esophagus sh...

Figure 29.4 (A) High‐resolution images of non‐dysplastic Barrett’s esophagus...

Figure 29.5 Visible lesions identified by high‐definition white‐light endosc...

Chapter 30

Figure 30.1 Common esophageal dilators. Clockwise from top: Maloney bougies,...

Figure 30.2 Markings on two bougie dilators. The American markings are from ...

Figure 30.3 The complicating role of inflammation and pills in stricture man...

Figure 30.4 (A) Peptic stricture with severe esophagitis in an elderly veter...

Figure 30.5 The association of Schatzki rings and GERD. The actual probabili...

Figure 30.6 Esophageal web in the proximal esophagus in a patient with Plumm...

Figure 30.7 Patient with recalcitrant dysphagia and lichen planus. A 66‐year...

Figure 30.8 Endoscopic balloon dilation followed by intralesional steroid in...

Figure 30.9 Benign anastomotic stricture with a diameter of 5 mm. (A) Needle...

Figure 30.10 Anastomotic stricture before and after placement of a covered m...

Figure 30.11 Clinical outcomes of patients with refractory benign esophageal...

Figure 30.12 Method of esophageal self‐dilation. After lubrication with wate...

Figure 30.13 Suggested algorithm for stricture dilation and management. Simp...

Chapter 31

Figure 31.1 Cobblestoning of the posterior pharynx.

Figure 31.2 Normal laryngeal endoscopy.

Figure 31.3 (A) Leukoplakia; (B) bilateral vocal fold edema and thick mucus;...

Figure 31.4 Proposed diagnostic/treatment algorithm for EER.

Chapter 32

Figure 32.1 Major mechanisms by which gastroesophageal reflux can induce pul...

Figure 32.2 Abnormal bolus exposure time on MII‐pH was predictive of (A) pre...

Figure 32.3 Evidence for antireflux therapy in the lung transplant populatio...

Chapter 35

Figure 35.1 Drawing of a LINX device in the open and closed position, and si...

Figure 35.2 As each bead separates, the magnetic force decays.

Figure 35.3 ex vivo porcine stomach demonstrating inherent LES yield pressur...

Figure 35.4 Initial view of hiatus – in this case, minimal if any hiatal her...

Figure 35.5 Formal crural dissection prior to repair.

Figure 35.6 Crural repair until no gap is present between the untensioned es...

Figure 35.7 Sizing method of closing the sizer until the white flexible tip ...

Figure 35.8 Additional sizing method of closing the sizer, compressing the e...

Figure 35.9 LINX device in place, lying noncompressively and obliquely along...

Figure 35.10 GERD‐HRQL scores post‐MSA. Single series of 134 patients, all f...

Figure 35.11 Subjective outcomes of patients post‐MSA up to 10 years.

Figure 35.12 Esophageal acid exposure in 134 patients at least six years pos...

Figure 35.13 Pre‐ and postoperative manometric findings in LINX patients....

Figure 35.14 Forest plot favors fewer gas‐bloat symptoms with MSA.

Figure 35.15 Forest plot ability to vomit, favors MSA.

Figure 35.16 Forest plot ability to belch, Favors MSA.

Figure 35.17 Comparison of LINX MSA to Angelchik Prosthesis.

Figure 35.18 Time to presentation of erosion by year.

Figure 35.19 Prevalence (%) of the patients requiring dilation by year (2013...

Chapter 36

Figure 36.1 Distributions of GERD‐related disorders according to sex, geogra...

Figure 36.2 Obesity has been associated with increased intragastric pressure...

Chapter 37

Figure 37.1 Endoscopic examination of a squamous cell carcinoma. (A) View of...

Figure 37.2 Endoscopic ultrasound examination demonstrates a T1N0 lesion (ar...

Figure 37.3 Endoscopic ultrasound examination demonstrates a T3N1 lesion, an...

Figure 37.4 Endoscopic examination in a patient with long‐segment Barrett’s ...

Figure 37.5 Endoscopic examination in a patient with dysphagia and weight lo...

Figure 37.6 Granular cell tumor (arrow indicates lesion).

Figure 37.7 Squamous papilloma (arrow indicates lesion).

Chapter 38

Figure 38.1 Schematic representation of tumor and nodal stage in esophageal ...

Figure 38.2 Cap EMR technique. (A) Saline injection to raise the lesion; (B)...

Figure 38.3 Band EMR technique. (A) Deployment of the snare over banded muco...

Figure 38.4 The initial step in endoscopic resection is to create a submucos...

Figure 38.5 Methods of using endoscopic knives for initial incision in endos...

Figure 38.6 Comparable overall survival of patients with T1a esophageal aden...

Figure 38.7 Forest plot of studies comparing overall five‐year survival betw...

Chapter 39

Figure 39.1 Clinical TNM classification (8th edition) of esophageal carcinom...

Figure 39.2 Endoscopic ultrasonography for staging of esophageal carcinoma. ...

Figure 39.3 Positron emission tomography scan showing uptake of 18‐fluorodeo...

Figure 39.4 Abdominal stage of fully minimally invasive Ivor Lewis esophagec...

Figure 39.5 Thoracic stage of fully minimally invasive Ivor Lewis esophagect...

Figure 39.6 Pragmatic algorithm for the multidisciplinary management of esop...

Chapter 40

Figure 40.1 Epidemiology of eosinophilic esophagitis.

Figure 40.2 Pathogenesis of eosinophilic esophagitis.

Figure 40.3 Barium esophagram images of eosinophilic esophagitis demonstrati...

Figure 40.4 Endoscopic images of eosinophilic esophagitis demonstrating typi...

Figure 40.5 Histopathology of eosinophilic esophagitis. Features illustrated...

Figure 40.6 Therapeutic endpoints in eosinophilic esophagitis.

Chapter 41

Figure 41.1 A 70‐year‐old male with a history of kidney transplantation and ...

Figure 41.2 An 18‐month‐old boy presented with intermittent right lower quad...

Figure 41.3 A 19‐year‐old female presented to the emergency room after swall...

Figure 41.4 A 50‐year‐old female with a history including Roux‐en‐Y presente...

Figure 41.5 Five physiological sites of narrowing in the esophagus.

Figure 41.6 Example of a foreign body box. Having the instruments in a box s...

Figure 41.7 Examples of devices used for retrieval of foreign bodies. From l...

Figure 41.8 Examples of devices used to grasp foreign bodies. From left to r...

Figure 41.9 Examples of instruments used to prevent endoscopic damage from f...

Figure 41.10 This patient had a history of recurrent food bolus impactions 1...

Chapter 42

Figure 42.1 Doxycycline induced esophagitis.

Chapter 43

Figure 43.1

Candida

esophagitis. (A) Biopsy of the mucosa and plaque shows t...

Figure 43.2

Herpes simplex

virus esophagitis. (A) Characteristic multinuclea...

Figure 43.3

Cytomegalovirus

esophagitis. Large, deep, hemicircumferential ul...

Figure 43.4 Idiopathic esophageal ulcer. Two angles of a well‐circumscribed ...

Chapter 44

Figure 44.1 Timing of tissue damage and repair after caustic injury of the e...

Figure 44.2 Proposed algorithm for evaluation and management of patients wit...

Chapter 45

Figure 45.1 Images of esophageal perforation. (A, B) Endoscopic and radiogra...

Figure 45.2 Esophageal stent placement. (A) Visualization of acute postsurgi...

Figure 45.3 Through‐the‐scope clip closure. (A) Visualization of esophageal ...

Figure 45.4 Over‐the‐scope clip closure. (A) Visualization of spontaneous es...

Figure 45.5 Endoscopic sutured closure. (A) Visualization of postsurgical es...

Figure 45.6 Novel endoscopic techniques. (A) Endoscopic vacuum therapy; (B) ...

Chapter 46

Figure 46.2 Pemphigus vulgaris: (A) Erosions with surrounding erythema invol...

Figure 46.1 Mucous membrane pemphigoid: (A) Ulceration with surrounding eryt...

Figure 46.3 Lichen planus: (A) Flat papules with Wickham striae on dorsal ha...

Figure 46.4 Acral sclerodactyly in systemic sclerosis.

Figure 46.5 Gottrons papules on knucles and nailfold erythema of the dorsal ...

Chapter 47

Figure 47.1 Typical high‐resolution manometry findings in older patients. (A...

Figure 47.2 Endoscopic and radiographic images of a patient undergoing endos...

Figure 47.3 High‐resolution manometry showing esophagogastric junction outfl...

Figure 47.4 High‐resolution manometry showing typical findings of scleroderm...

Figure 47.5 Barium radiograph from a 72‐year‐old patient with dysphagia aort...

Guide

Cover Page

Title Page

Copyright

Dedication

Contributors

Preface

About the Companion Website

Table of Contents

Begin Reading

Index

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The Esophagus

Sixth Edition

Editors‐in‐Chief

Joel E. Richter MD, FACP, MACG

Hugh F. Culverhouse Chair of Esophagology

Professor and Director

Division of Digestive Diseases and Nutrition

Joy McCann Culverhouse Center for Swallowing Disorders

University of South Florida Morsani College of Medicine

Tampa, FL, USA

Donald O. Castell MD

Professor Emeritus of Medicine

Esophageal Disorders Program, Division of Gastroenterology, Department of Internal Medicine

Medical University of South Carolina

Charleston, SC, USA

Associate Editors

David A. Katzka MD

Division of Gastroenterology and Hepatology

Mayo Clinic

Rochester, MN, USA

Philip O. Katz MD

Division of Gastroenterology and Hepatology

Jay Monahan Center for Gastrointestinal Health

Weill Cornell Medicine

New York, NY, USA

André Smout MD

Department of Gastroenterology and Hepatology

Amsterdam University Medical Center

Amsterdam, The Netherlands

Stuart Spechler MD

Division of Gastroenterology

Baylor University Medical Center at Dallas

Dallas, TX, USA

Michael F. Vaezi MD, PhD, MSc

Division of Gastroenterology, Hepatology, and Nutrition

Director Clinical Research and Esophageal Center

Vanderbilt University Medical Center

Nashville, TN, USA

This edition first published 2021© 2021 John Wiley & Sons Ltd

Edition HistoryBlackwell Publishing Ltd (5e, 2012); Previously published by Lippincott Williams and Wilkins, 2004

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The right of Joel E. Richter, Donald Castell, David Katzka, Philip O. Katz, André Smout, Stuart Spechler, and Michael Vaezi to be identified as the authors of the editorial material in this work has been asserted in accordance with law.

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