Esophageal cancer differential diagnosis: Difference between revisions
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*[[Gastric ulcer]] | *[[Gastric ulcer]] | ||
*[[Stomach cancer]] | *[[Stomach cancer]] | ||
Esophageal adenocarcinoma must be differentiated from other causes of dysphagia, odynophagia and food regurgitation such as GERD, and esophageal stricture. | |||
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!Manifestations | |||
!Diagnostic tools | |||
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|Achalasia | |||
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* Dyspnea<ref>{{cite book | last = Ferri | first = Fred | title = Ferri's clinical advisor 2015 : 5 books in 1 | publisher = Elsevier/Mosby | location = Philadelphia, PA | year = 2015 | isbn = 978-0323083751 }}</ref> | |||
*[[Dysphagia]] for solids and liquids is the most common feature, being seen in 91 % and 85% of patients respectively<ref name="pmid23871090">{{cite journal| author=Boeckxstaens GE, Zaninotto G, Richter JE| title=Achalasia. | journal=Lancet | year= 2013 | volume= | issue= | pages= | pmid=23871090 | doi=10.1016/S0140-6736(13)60651-0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23871090 }}</ref> | |||
*[[Regurgitation]] of undigested food occurs in 76-91% of patients<ref name="pmid23871090">{{cite journal| author=Boeckxstaens GE, Zaninotto G, Richter JE| title=Achalasia. | journal=Lancet | year= 2013 | volume= | issue= | pages= | pmid=23871090 | doi=10.1016/S0140-6736(13)60651-0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23871090 }} </ref> | |||
*[[Cough]] mainly when lying down in 30%<ref name="pmid23871090">{{cite journal| author=Boeckxstaens GE, Zaninotto G, Richter JE| title=Achalasia. | journal=Lancet | year= 2013 | volume= | issue= | pages= | pmid=23871090 | doi=10.1016/S0140-6736(13)60651-0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23871090 }} </ref> | |||
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* Esophagogastroduodenoscopy findings include a dilated esophagus with residual food fragments, normal mucosa and occasionally [[candidiasis]] (due to the prolonged stasis). | |||
* Barium swallow shows the characteristic bird's beak appearance. | |||
[[Image:Acha.jpg|center|300px|thumb|Barium swallow showing bird's beak appearance - By Farnoosh Farrokhi, Michael F. Vaezi. - Idiopathic (primary) achalasia. Orphanet Journal of Rare Diseases 2007, 2:38(http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2040141), CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=2950922]] | |||
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|[[GERD]] | |||
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* Retrosternal burning chest pain. | |||
* Cough and hoarseness of voice. | |||
* May present with complications such as strictures and dysphagia. | |||
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* Upper GI endoscopy shows the complications such as esophagitis and barret esophagus. | |||
* Esophageal manometry may show decreased tone of the lower esophageal sphincter. | |||
* 24-hour esophageal pH monitoring may be done to confirm the diagnosis. | |||
[[Image:Barretts esophagus.jpg|center|300px|thumb|Barret's esophagus - By Samir धर्म - taken from patient with permission to place in public domain, Copyrighted free use, https://commons.wikimedia.org/w/index.php?curid=1595945]] | |||
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|[[Esophageal cancer|Esophageal carcinoma]] | |||
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*[[Dysphagia]] | |||
*[[Odynophagia]]- fluids and soft foods are usually tolerated, while hard or bulky substances (such as bread or meat) cause much more difficulty | |||
*[[Weight loss]] | |||
*[[Pain and nociception|Pain]], often of a burning nature, may be severe and worsened by swallowing, and can be spasmodic in character | |||
*[[Nausea]] and [[vomiting]] | |||
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* Upper GI endoscopy and esophageal biopsy the gold standard for the diagnosis of esophageal | |||
[[Image:Esophageal adenoca.jpg|center|300px|thumb|CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=2587715]] | |||
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|[[Esophageal spasm|Corckscrew esophagus]] | |||
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*Retrosternal chest pain that presents with or without food intake. | |||
*The condition is not progressive and not causing complications. | |||
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* Barium swallow shows the characteristic corckscrew appearance of the esophagus. | |||
[[Image:Nutcracker-esophagus-004.jpg|center|300px|thumb|Corckscrew esophagus - Case courtesy of Radswiki, Radiopaedia.org, rID: 11680]] | |||
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|[[Esophageal stricture]] | |||
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*Patient may present with the symptoms of the underlying GERD. | |||
*Dysphagia and odynophagia. | |||
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* Barium esophagography provides information about the site and the diameter of the stricture before the endoscopic intervention. | |||
[[Image:Peptic stricture.png|center|300px|thumb|Peptic stricture - By Samir धर्म - From en.wikipedia.org, Public Domain, https://commons.wikimedia.org/w/index.php?curid=1931423]] | |||
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==References== | ==References== | ||
Revision as of 12:31, 3 November 2017
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Esophageal cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Esophageal cancer differential diagnosis On the Web |
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American Roentgen Ray Society Images of Esophageal cancer differential diagnosis |
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Risk calculators and risk factors for Esophageal cancer differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
Esophageal cancer must be differentiated from gastroesophageal reflux disease (GERD), Barrett's esophagus, esophageal achalasia, gastritis, gastric ulcer, and stomach cancer.
Differentiating Esophageal cancer from other Diseases
Esophageal adenocarcinoma must be differentiated from other causes of dysphagia, odynophagia and food regurgitation such as GERD, and esophageal stricture.
| Manifestations | Diagnostic tools | |
|---|---|---|
| Achalasia |
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| GERD |
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| Esophageal carcinoma |
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| Corckscrew esophagus |
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| Esophageal stricture |
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References
- ↑ Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
- ↑ 2.0 2.1 2.2 Boeckxstaens GE, Zaninotto G, Richter JE (2013). "Achalasia". Lancet. doi:10.1016/S0140-6736(13)60651-0. PMID 23871090.