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Related Concept Videos

Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Esophageal Achalasia01:27

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Gastroesophageal Reflux Disease01:25

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...

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Related Experiment Video

Updated: Jul 15, 2026

Technical Considerations and Approach to Redo Foregut Surgery
04:14

Technical Considerations and Approach to Redo Foregut Surgery

Published on: September 22, 2023

Reversing esophageal discontinuity.

Mark B Orringer1

  • 1Section of General Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA. morrin@med.umich.edu

Seminars in Thoracic and Cardiovascular Surgery
|April 4, 2007
PubMed
Summary

Esophageal discontinuity, a life-saving procedure for severe gastric or esophageal damage, often requires complex reconstructive surgery. This article details the critical decisions and surgical nuances for restoring alimentary continuity in these challenging cases.

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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

Published on: April 17, 2020

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Technical Considerations and Approach to Redo Foregut Surgery
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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
09:40

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

Published on: April 17, 2020

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Trauma Surgery

Background:

  • Catastrophic esophageal or gastric disruption necessitates esophageal disconnection to prevent mediastinal soilage.
  • Current surgical approaches for esophageal discontinuity are not standardized, prioritizing immediate survival over future reconstruction.
  • Patients surviving initial complications often seek further surgery to restore eating function.

Purpose of the Study:

  • To explore the critical decision-making processes involved in reversing esophageal discontinuity.
  • To provide insights into the timing, preoperative assessment, surgical planning, and outcomes of esophageal reconstruction.
  • To address the limited literature on reestablishing alimentary continuity after esophageal disconnection.

Main Methods:

  • Review of surgical strategies for esophageal discontinuity reversal.
  • Analysis of factors influencing the timing and planning of reconstructive surgery.
  • Discussion of patient selection and preoperative preparation for complex esophageal surgery.

Main Results:

  • The decision to disconnect the esophagus is driven by life-threatening mediastinal soilage.
  • Restoring alimentary continuity presents significant surgical challenges due to patient variability.
  • Optimal timing and surgical planning are crucial for successful esophageal reconstruction outcomes.

Conclusions:

  • Reversing esophageal discontinuity requires careful consideration of multiple surgical and patient-specific factors.
  • Further research and standardized guidelines are needed for optimal management of esophageal discontinuity.
  • Successful reestablishment of alimentary continuity can significantly improve patient quality of life.