Thoracic Key

Fig. 4.1 Carlos Chagas (Source: National Library of Medicine) The disease is caused by the protozoan Trypanossoma cruzy (Fig. 4.2), a flagellated protozoan that is transmitted to humans by a…

Fig. 15.1 Barium swallow. Dilated and sigmoid esophagus A dilated and sometimes sigmoid esophagus can be present at the time of the initial presentation, while others patients may develop it…

Fig. 13.1 Typical epiphrenic diverticulum in association with achalasia It is estimated that fewer than 10 % of patients develop symptoms or complications of their diverticula in the absence of…

Fig. 10.1 Organization of the operating room for a laparoscopic Heller myotomy Placement of the Trocars Five trocars are used for the operation (Fig. 10.2). Fig. 10.2 Position of trocars…

Fig. 2.1 Esophagogastroduodenoscopy (EGD) is used in the assessment of dysphagia, and to evaluate for complications of achalasia. Here, EGD demonstrated evidence of white plaques in the esophagus, signifying a…

Fig. 11.1 Dissection along right crus At this point it is helpful to place a penrose drain around the esophagogastric junction, securing it loosely anteriorly with an endoloop suture. This…

Fig. 7.1 A 2 cm vertical mucosotomy is performed after the submucosal space is injected with saline and methylene blue. This is performed 10 cm proximal to the GE junction…

Fig. 3.1 Eckardt’s score Diagnostic Evaluation A thorough evaluation to establish the diagnosis should be performed in all patients with symptoms suggestive for achalasia [2]. Upper Endoscopy It is usually…

Fig. 17.1 Dilated esophagus Fig. 17.2 Dilated and sigmoid esophagus Operative Technique Esophagectomy for achalasia requires resection of the non-functioning part of the esophagus and reconstruction to the functioning striated…

Fig. 8.1 Left thoracoscopy myotomy. (a) Position of trocars. (b) Myotomy The ability of extending the myotomy easily onto the gastric wall and the ability of adding a partial fundoplication…