too short esophagus
Introduction
Brief introduction of esophagus The esophagus is too short to have congenital and acquired nature. Excessive esophageal esophagia can be secondary to inflammatory esophageal fibrosis, reflux of congenital gastropares, esophageal ulcers, etc. Typical symptoms are difficulty swallowing, swallowing pain and vomiting. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: hiatal hernia
Cause
Esophageal too short cause
Congenital esophagus is too short (15%):
Congenital esophageal too short may be due to the left or right thoracic-peritoneal incision closure, resulting in the failure of the lower end of the esophagus. Furthermore, part of the stomach associated with congenital short esophagus has no serosa, the blood vessels are from the thoracic aorta, and are never in the normal position in the abdominal cavity, which is different from the true esophageal hiatus.
Esophageal development (20%):
Part of the stomach is moved to the sputum, and the length of the esophagus is shorter than normal, and the normal anatomical position of the stomach under the diaphragm cannot be maintained. The blood supply to the stomach is supplied directly from the branch of the thoracic aorta. There is no bag-shaped folded peritoneum on the anterior side of the stomach that protrudes upward into the iliac crest. The peritoneal anatomy of the sacral hole is normal.
Acquired short esophagus (25%):
Acquired short esophagus is a secondary shortening of the esophagus. As the diaphragmatic hernia increases, the upper part of the stomach passes through the enlarged hole and enters the thoracic cavity. The part of the stomach located in the chest still covers the serosa. The blood vessels originate from the abdominal cavity, and the acquired esophagus passes. Short can be secondary to inflammatory esophageal fibrosis, reflux of congenital gastric fistula, esophageal ulcers, etc.
Pathogenesis
The inner esophagus is too short and a congenital esophagus is too short. From the outside, the esophageal length seems normal, and there is no abnormality in the esophageal hiatus. The cardia is located in the original position of the abdominal cavity, but this abnormality is the lower part of the esophagus. /3 The esophagus is covered by gray mucous membrane, histologically confirmed as gastric mucosa, its wrinkles are gastric folds, and there are ducts secreting hydrochloric acid and pepsin. Therefore, the inner esophagus is too short to be a mucosal shortening or a shortening of the esophageal lumen.
Prevention
Esophageal too short prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Esophageal short complications Complications
Esophageal hiatus hernia.
Symptom
Esophageal too short symptoms common symptoms swallowing pain swallowing difficulties
Typical symptoms are dysphagia, swallowing pain, and vomiting. The disease may not be discovered until adulthood, when X-ray is performed due to initial symptoms.
Examine
Esophageal too short inspection
X-ray, endoscopy and biopsy.
Diagnosis
Short diagnosis of esophagus
diagnosis
X-ray, endoscopy and biopsy can confirm the diagnosis.
Differential diagnosis
In the diagnosis of hiatal hernia, there is also a so-called "short esophagus" sign. When esophageal barium angiography is seen, the cardia rises and the esophagus shortens. This esophageal shortening is shortened after the esophageal longitudinal muscle contraction, so it is congenital. Short and small, "short esophagus" should be the blood supply to the stomach in the chest part directly from the aorta, and its esophagogastric junction can not be reduced to congenital short esophagus below the diaphragm, but also congenital esophageal too short In patients with hiatal hernia, at this time, regardless of lying position or standing position, the cardia is fixed on the sac, and the sac is bell-shaped. This disease is also different from the acquired short esophagus. The latter is a secondary shortening of the esophagus. Large, causing the upper part of the stomach to cross the enlarged hole into the chest cavity, part of the stomach located in the chest is still covered with the serosa, the blood vessels originate from the abdominal cavity, and the acquired esophageal too short can be secondary to inflammatory esophageal fibrosis, congenital gastroparesis Reflux, esophageal ulcer, etc.; surgical short esophagus secondary to esophageal fibrosis caused by esophagectomy and hiatal hernia surgery; in addition, adults have functional esophageal dysfunction, when the abdominal organs are stimulated to cause fans When the nerve is reflected, it can cause shortening of the esophagus. If there is simultaneous relaxation of the diaphragmatic sulcus, part of the stomach can be pulled into the chest cavity. The clinical manifestations of adults are similar to ulcer symptoms, angina pectoris, shortness of breath, difficulty in swallowing, bleeding, gastroesophageal reflux, etc. Familiarity with these performances can help to understand and identify the congenital esophagus too short.
