The Esophagus

THE ESOPHAGUS The Esophagus investigates the anatomy, physiology, and pathology of the esophagus. This sixth edition, revised and updated throughout, also explores the diagnosis and treatment of various esophageal conditions. It includes treatment guidelines approved by the two largest gastroenterology societies, the ACG and AGA, as befits a work co-edited by two former presidents of those organizations. Advancements in diagnostics are presented, as are developments in the surgical and drug therapies. Presented in full colour, and boasting an unrivalled team of editors and contributing authors, The Esophagus Sixth Edition will find a home wherever the anatomy, physiology, and pathology of the esophagus are studied and taught. This book is accompanied by a website containing all the figures from the book in PowerPoint format. www.wiley.com/go/richter/esophagus6e Praise for the Fifth Edition: “There is absolutely no doubt that this edition of the textbook will maintain its status as the go-to reference for esophageal conditions, and will remain a highly utilized and clinically useful resource for novice and experienced physicians and surgeons alike.” (Gastroenterology, 1 July 2013)

Deglutition or a swallow begins as a voluntary act in the oral cavity but proceeds autonomously in the pharynx and esophagus. Bilateral sequenced activation and inhibition of more than 25 pairs of muscles of mouth, pharynx, larynx, and esophagus is required during a swallow. A single swallow elicits peristalsis in the pharynx and esophagus along with relaxation of upper and lower esophageal sphincters. Multiple swallows, at closely spaced time intervals, demonstrate deglutitive inhibition; sphincters remain relaxed during the entire period, but only the last swallow elicits peristalsis. Laryngeal inlet closure or airway protection is very important during swallow. Upper part of the esophagus that includes upper esophageal sphincter is composed of skeletal muscles, middle esophagus is composed of a mixture of skeletal and smooth muscles, and lower esophagus, including lower esophageal sphincter, is composed of smooth muscles. Peristalsis progresses in seamless fashion, despite separate control mechanism, from the skeletal to smooth muscle esophagus. The esophagus's circular and longitudinal muscle layers contract synchronously during peristalsis. Sphincters maintain continuous tone; neuromuscular mechanisms for tonic closure in the upper and lower esophageal sphincters are different. Lower esophageal sphincter transient relaxation, belching mechanism, regurgitation, vomiting, and reflux are mediated via the brain stem. Table of Contents: Introduction / Central Program Generator and Brain Stem / Pharynx-Anatomy, Neural Innervation, and Motor Pattern / Upper Esophageal Sphincter / Neuromuscular Anatomy of Esophagus and Lower Esophageal Sphincter / Extrinsic Innervation: Parasympathetic and Sympathetic / Interstitial Cells of Cajal / Recording Techniques / Motor Patterns of the Esophagus-Aboral and Oral Transport / Deglutitive Inhibition and Muscle Refractoriness / Peristalsis in the Circular and Longitudinal Muscles of the Esophagus / Neural and Myogenic Mechanism of Peristalsis / Central Mechanism of Peristalsis-Cortical and Brain Stem Control / Peripheral Mechanisms of Peristalsis / Central Versus Peripheral Mechanism of Deglutitive Inhibition / Neural Control of Longitudinal Muscle Contraction / Modulation of Primary and Secondary Peristalsis / Neural Control of Lower Esophageal Sphincter and Crural Diaphragm / Lower Esophageal Sphincter / Swallow-Induced LES Relaxation / Crural Diaphragm Contribution to EGJ and Neural Control / Transient LES Relaxation and Pharmacological Inhibition / Compliance of the EGJ / References

An inside look at the "sport" of competitive eating and its contestants, with descriptions of the contest circuit, from small-town pie-eating competitions to such international spectaculars as the Nathan's hot-dog eating contest at Coney Island

This definitive reference offers a comprehensive review of the radiology of esophageal disease. Details the use of double contrast techniques for recognizing subtle mucosal abnormalities and diagnosing early conditions--including the erosions of reflux esophagitis and the small lesions of early gastric cancer. Discusses the value of new cross-sectional imaging techniques such as CT and MRI for differential diagnosis and for staging malignant diseases.

Barrett’s Esophagus: Emerging Evidence for Improved Clinical Practice is a comprehensive reference on the treatment and new imaging modalities of Barrett’s Esophagus for researchers, clinicians, and scholars. Each chapter is composed from the perspective of investigators who summarize the data as well as the reasoning behind why those studies were conceived. In addition, the future directions of research are discussed within each chapter, providing insights from the investigators. Research questions are described, and cutting-edge applications are explained. Each chapter contains clinical scenarios to highlight the directions in which the research is, and should be, heading. Provides a perspective into the research behind Barrett’s Esophagus Emphasizes the emerging technologies in surveillance and treatment of Barrett’s Features clinical scenarios to highlight the directions in which research is, and should be, heading Includes coverage of current guidelines and discussions on where these guidelines fall short

Atlas of Esophagus and Stomach Pathology provides an image-based resource for those studying normal histology of the upper gastrointestinal tract, as well as the microscopic manifestations of developmental abnormalities, toxic insults, infectious diseases, inflammatory and autoimmune conditions, and neoplasia in the esophagus and stomach. Because modern gastrointestinal pathology practice centers on specimens obtained during endoscopic examination, the atlas focuses on biopsy pathology, providing “real-world” microscopic images and ancillary diagnostic studies for most commonly-encountered abnormalities and diseases affecting these two organs. The book is supplemented with endoscopic and special study images. Authored by nationally and internationally recognized pathologists, Atlas of Esophagus and Stomach Pathology is a valuable tool for both pathologists-in-training seeking to make “new acquaintances”, and practicing surgical pathologists in need of a quick visual reference in recalling “old friends” in the world of diagnostic gastrointestinal pathology.

This book is the first of a planned series of texts on pathology of the gastrointestinal tract. The authors have long thought that texts on pathology ofthe gastrointestinal tract tend to cover the clinical aspects, pathophysiology, and radiology in a rather sketchy fashion. The pa thologist is often left with an incomplete understanding of the problem at hand. Indeed, even the pathologic aspects of diseases of the esophagus are given relatively short shrift in textbooks on gastrointestinal pa thology. In an effort to rectify this situation, the authors have culled infor mation from a wide variety of sources to describe in greater depth than usual, the clinical pl"esentation, diagnosis, and pathophysiology, and the morphologic aspects of esophageal disease. While the book is pri marily geared for pathologists, it is expected that this volume will also be an aid to internists, gastroenterologists, surgeons, radiologists, and other clinicians who wish to gain a better understanding of the path ologic processes involved in the many clinical conditions in which esoph ageal dysfunction is a factor. Pathologists are being challenged by new diagnostic puzzles in the esophageal area; it is hoped that this text will assist them in meeting these challenges. The esophagus tends to be neglected in autopsy examinations despite its important contribution to human illness. Much remains to be learned.