17th July 2023

Other Oesophageal Disorders

Mallory-Weiss Tear ― an oesophageal mucosal tear, often caused by severe vomiting or coughing. This can result in an upper GI bleed.
Boerhaave’s perforation ― a sudden rupture of the oesophagus due to raised intra-oesophageal pressure and reduced intrathoracic pressure (e.g. severe vomiting). Patients may have severe retrosternal chest pain (intrathoracic perforation), abdominal pain with radiation to the shoulders (intra-abdominal perforation) and subcutaneous emphysema.
Eosinophilic oesophagitis ― a history may mention a young patient with a history of recurrent food bolus obstruction (perhaps with certain trigger foods causing an allergic reaction). Patients will show no improvement to PPI trials. Endoscopy may be normal but oesophageal rings may be present. Diagnostic biopsies show ≥15 eosinophils per high power field. Treatments can be difficult and include eliminating trigger foods, topical steroids and dilatation where oesophageal strictures are present.
Plummer-Vinson syndrome ― a triad of iron deficiency anaemia, dysphagia (secondary to an oesophageal web) and glossitis/angular cheilitis. Oesophageal webs can result in dysphagia.

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