GASTROENTEROLOGY LITERATURE REVIEW SESSION

NOVEMBER 16, 2000

 Boyce HW.  Endoscopic definitions of esophagogastric junction regional anatomy.  Gast Endosc 2000;51:586-592.

 1.  The “sniff test” can be used to:

a.      see if the patient is alive

b.      have the patient smell the endoscope

c.      identify the diaphragmatic hiatus

d.      increase the O₂ sat of the patient

 True or False

 2.  The SCJ normally lies at or below the diaphragmatic hiatus, it may move cephalad as the esophagus is insufflated with air.

 3.  The total length of the LES is usually 2-3 cm, it starts at the mucosal rosette and ends at the SCJ

 4.  Lugol’s solution (iodine) stains the glycogen-rich squamous epithelium, but not the normal columnar epithelium of the stomach.

 5.  The most hypertonic part of the LES is in the proximal portion, this is the area in which botulinum toxin should be injected for the treatment of achalasia.

 6.  In the absence of a hiatal hernia, it is abnormal to visualize the squamocolumnar junction while retroflexing the endoscope in the stomach and examining the esophagogastric junction.

 7.  The beginning of the proximal edge of the gastric cardia fold mark the esophagogastric junction.

 8.  The presence of proximal gastric folds more than 2cm cephalad to the diaphragmatic hiatus identifies the presence of a hiatal hernia.

 9.  Opening of the LES with air insufflation is a marker of low lower esophageal pressure.

 10.  While reading this paper

a.      your eyes rolled cephalad 1cm

b.      your head flexed anteriorly at the angle formed by your neck and your clavicle

c.      your head extended posteriorly 5 cm, forming an acute angle with the vertebral column and an obtuse angle with the sternum

d.      your nose met the mucosal rosette depicted on figure 7A, while your head traversed anteriorly 25 cm in its trajectory to meet the table while you snoozed.

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