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11 Cards in this Set
- Front
- Back
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Medical Term for Heartburn
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Pyrosis
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What causes hearburn?
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>1/2 = decreased LES tone
~1/2 = hiatal hernia (?coexisting) else: Gastric Outlet Obstrx, Decreased Esophageal Motility |
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#1 DDx for apparent heartburn
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CAD
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Workup for Hearburn
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EKG (RO: CAD)
CXR EGD UGI contrast with esophogram 24h acid analysis Manometry |
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Surgical Indications for Heartburn
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Intractible to Medical Tx:(PPI, bed elevation, last meal at 3h qhs, no etoh, mint, fats)
Respiratory Problems (2/2 reflux/aspiration) Severe Esophageal Injury (Ulcers, hemorrhage, strix, barrett's) |
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% of GERD pts with Barrett's
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% of Barrett's --> AdenoCA
10%, 7% lifetime |
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Tx: Barrett's
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Endoscopic Muscoal Resexn & Photodynamic therapy
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Lap Nissen: What, Mechanism, Success Rate, Complixns
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360 fundoplication (fundus pulled 180 around both sides & joined across esophagus
Mechanism: increases LES tone, elongates LES, returns LES to abodminal cavity Success Rate: 70-95% Post Op Complixns: 1. Gas Bloat(inability to burp/vomit) 2. Strix 3. Dysphagia 4. Splenic Injury --> splenectomy 5. Esophageal perforation 6. Pneumothorax |
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Belsey Mark 4
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Thoracic Approach, 270 fundoplication (suturing fundus to esophagus, not fundus to fundus)
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Hill Procedure
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Arcuate Ligament Repair, Gastropexy to diaphgragm
(For Hiatal hernia) |
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Toupet Procedure
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Incomplete Nissen - 100* around either side and then suture fundus longitudinally to the esophagus. Used if pt has GERD + Decrased Esophageal Motility
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