By Shanda H. Blackmon, Min P. Kim, Karen J. Dickinson
This atlas offers a accomplished, cutting-edge evaluate of all interventions that pertain to the esophagus. It contains a evaluation of the present staging modalities, ablation applied sciences, resection and reconstruction concepts, and illness type. Evidence-based guidance relating to how every one intervention is selected also are incorporated. With colour illustrations and images for every surgical procedure, the atlas info particular anatomic subject matters comparable to micro-anatomy of Barrett’s and Dysplasia, EMR pathology, endoscopic ultrasound, and traditional surgical anatomy. each one intervention is gifted in activity structure as a role checklist to be checked-off as each one step is completed.
Written by way of specialists within the box, Atlas of Esophageal ailment and Intervention: A Multidisciplinary Approach serves as a helpful source for any practitioner who plays esophageal intervention and may consultant new surgeons and gastroenterologists into the hybrid multidisciplinary method of this disease.
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7 (a) Barrett’s esophagus, indefinite for dysplasia (H & E, ×100). (b) Barrett’s esophagus, indefinite for dysplasia (H & E, ×400). The cells show cytologic features of dysplasia that include nuclear enlargement, hyperchromasia, and some nuclear stratification. Diagnostic features of high-grade dysplasia are not seen a b Nuclear enlargement, hyperchromasia and focal stratification Goblet cell Mitotic figure approaching gland lumen 2 Histologic Anatomy 29 Barrett’s Esophagus, Low-Grade Dysplasia Low-grade dysplasia is characterized by nuclear crowding, stratification, atypia, and increased mitotic figures (Fig.
1 Normal distal esophagus, gastroesophageal (GE) junction, and stomach after formalin fixation. The squamous mucosa is pinkish white, the GE junction is well demarcated, and the stomach shows normal darker pink columnar mucosa with rugae 2 Histologic Anatomy 21 Epithelium Basement membrane Lamina propia Muscularis mucosa Submucosa Muscularis propria (circular and longitudinal muscle) Paraesophageal tissue (fat) Fig. 2 Schematic view of a normal full-thickness section of esophagus 22 B. Gorman Epithelium Basement membrane Lamina propria Muscularis mucosa Submucosa Submucosal glands and ducts Muscularis propria Fig.
When there is unusual pulsion or pressure at the lower esophagus, then a lower esophageal diverticulum forms and is named epiphrenic diverticulum. In the case of pulsion diverticula, a myotomy typically is performed to prevent recurrence at the time of diverticulectomy 1 Gross Anatomy 17 Longitudinal esophageal muscle Circular esophageal muscle Longitudinal esophageal muscle Circular esophageal muscle Esophageal mucosa Submucosa Phrenoesophageal ligament (ascending or upper limb) Cardiac notch Phrenoesophageal ligament (descending limb) Supradiaphragmatic fascia Infradiaphragmatic fascia Diaphragm Fundus Window cut in middle circular muscle layer of stomach Gradual slight muscular thickening Peritoneum Subhiatal fat ring Cardiac notch Z-line Outer longitudinal muscle layer of stomach (cut) Cardiac part of stomach Gastric folds (rugae) Fig.