Chapter 6 surgical diseases of the esophagus

DYSPHAGIA

Dysphagia, or swallowing disorder, is a common symptom that unifies a group of diseases in which one organ is affected: the esophagus.

Anatomical features. The esophagus is a part of the digestive system that connects the pharynx to the stomach. Its wall consists of a mucosa and a two-layered muscle membrane. The esophagus is covered with the peritoneum only in the distal section, in the upper abdominal cavity, where it extends from the diaphragm to the cardiac section of the stomach. Usually this part is from 2 to 4 cm long. Along the esophagus, there are three physiological constrictions: the place where the pharynx enters the esophagus, the level of tracheal bifurcation, and the place where the digestive tract passes through the diaphragm and enters the stomach (Fig. 6.1). In places of physiological constrictions of the esophagus, various pathological processes (foreign bodies, burns) are often localized. The esophagus is located in the posterior mediastinum and is in close proximity to several vital formations that can be involved in the pathological processes that occur in the esophagus (aorta, trachea and vagus nerves with their branches, the superior and inferior laryngeal nerves).

Fig. 6.1. Anatomy of the esophagus

The main symptom of esophageal diseases is dysphagia, a swallowing disorder. In addition, in diseases of the esophagus, chest pains, regurgitation of food and esophageal vomiting are observed. The latter, unlike stomach vomiting, occurs during meals. Salivation is also often observed.

In addition to the main signs of diseases of the esophagus, a number of symptoms are observed on the part of other organs of the breast located near the esophagus and involved in the pathological process (chest pains and, depending on whether pleura is involved in the pathological process or not; shortness of breath; Horner's syndrome - constriction of the palpebral fissure and pupil during invasion in the sympathetic nerve; hoarseness of the voice when the inferior laryngeal nerve is involved in the process; pain in the heart).