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Esophageal Surgery

Caustic ingestion can cause severe injury to the esophagus and the stomach. The severity and extent of esophageal and gastric damage resulting from a caustic ingestion depend upon the following factors

Corrosive properties of the ingested substance

Amount, concentration, and physical form (solid or liquid) of the agent

Duration of contact with the mucosa

Most ingestion occurs in children and the remainder in psychotic, suicidal, and alcoholic subjects. More than 5000 caustic ingestions are reported annually in the United States; these ingestions are the leading cause of esophageal strictures in children

Children frequently expectorate most of the caustic agent before swallowing, thereby minimizing injury In comparison, suicidal patients often ingest larger amounts of caustic agents than those who accidentally swallow these agents; as a result, they are likely to have more severe esophageal and gastric damage. Prevention plays a key role in reducing the incidence of corrosive ingestion, especially in children, yet this goal is far from being reached in developing countries, where such injuries are largely unreported

Esophageal Cancer

Esophageal cancer is cancer that occurs in the esophagus a long, hollow tube that runs from your throat to your stomach. Your esophagus carries food you swallow to your stomach to be digested.

Esophageal cancer usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus, but in people in the United States, it occurs most often in the lower portion of the esophagus. More men than women get esophageal cancer.

Symptoms

Signs and symptoms of esophageal cancer include:

Difficulty swallowing (dysphagia)

Weight loss without trying

Chest pain, pressure or burning

Fatigue

Frequent choking while eating

Indigestion or heartburn

Coughing or hoarseness

Early esophageal cancer typically causes no signs or symptoms.

Causes

It's not clear what causes esophageal cancer. Esophageal cancer occurs when cells in your esophagus develop errors (mutations) in their DNA. The errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor in the esophagus that can grow to invade nearby structures and spread to other parts of the body.

Types of esophageal cancer

Esophageal cancer is classified according to the type of cells that are involved. The type of esophageal cancer you have helps determine your treatment options. Types of esophageal cancer include:

Adenocarcinoma: Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma occurs most often in the lower portion of the esophagus. Adenocarcinoma is the most common form of esophageal cancer in the United States, and it affects primarily white men.

Squamous cell carcinoma: The squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the middle of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.

Other rare types: Rare forms of esophageal cancer include choriocarcinoma, lymphoma, melanoma, sarcoma and small cell cancer.

Risk Factors

It's thought that chronic irritation of your esophagus may contribute to the DNA changes that cause esophageal cancer. Factors that cause irritation in the cells of your esophagus and increase your risk of esophageal cancer include:

Drinking alcohol

Having bile reflux

Chewing tobacco

Having difficulty swallowing because of an esophageal sphincter that won't relax (achalasia)

Drinking very hot liquids

Eating few fruits and vegetables

Eating foods preserved in lye, such as lutefisk, a Nordic recipe made from whitefish, and some olive recipes

Having gastroesophageal reflux disease (GERD)

Being obese

Having precancerous changes in the cells of the esophagus (Barrett's esophagus)

Undergoing radiation treatment to the chest or upper abdomen

Smoking.


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