Esophagus

Abstract

This chapter will include the most important anatomical landmarks and differential diagnosis of esophagus across various imaging modalities. The key questions included are common questions asked during the rotation as well as questions that will help differentiate disease processes that may look very similar at an initial glance. Many of the questions will include high-yield differential diagnosis for common findings in imaging.

The questions will include landmarks to indicate where esophagus starts and ends, characterizing esophageal carcinoma, diagnosing Zenker’s diverticulum, vascular and lymphatic system associated with esophagus, use of esophagography, differential for dilated esophagus, and many more.

At which vertebrae level does the esophagus enter the thorax?	T1
At which vertebrae does the esophagus end?	T10
What is the space lateral to esophagus?	Carotid spaces
What is the most likely diagnosis of ill-defined esophageal thickening?	Esophageal carcinoma
What is the most likely diagnosis of air-fluid level found in the pharyngoesophageal junction?	Zenker diverticulum
At which vertebral level is the Zenker’s diverticulum most often found?	Esophageal herniation at C5–C6 level (Killian’s dehiscence)
What are the blood supplies to and venous drainage of cervical esophagus?	Inferior thyroid arteries and veins
What is the lymphatic drainage of esophagus?	Upper $\raisebox{1ex}{$2$}\!\left/ \!\raisebox{-1ex}{$3$}\right.$: posteriormediastinal nodes Lower $\raisebox{1ex}{$1$}\!\left/ \!\raisebox{-1ex}{$3$}\right.$: left gastricand celiac nodes
What are the two best imaging modalities to evaluate and classify hiatal hernia?	Barium esophagram and upper GI studies
What is fluoroscopic-guided esophagography finding of esophageal varices?	Serpiginous longitudinal filling defects
What are the differential diagnosis of dilated esophagus with distal stricture? [1]	1. Esophageal scleroderma 2. Esophageal achalasia 3. Reflux esophagitis 4. Esophageal carcinoma 5. Iatrogenic (i.e., status post fundoplication and vagotomy)