George Smith, a 55-year-old patient is admitted to the intensive care unit after a thoracotomy approach...

George Smith, a 55-year-old patient is admitted to the intensive care unit after a thoracotomy approach was used for an esophagectomy to remove an early stage adenocarcinoma of the distal esophagus and gastroesophageal junction. The patient has a history of GERD and Barrett’s esophagus. The patient sought medical treatment for dysphagia with solid foods, feeling that there was a lump in his throat and substernal pain with swallowing and subsequent regurgitation of undigested food and the development of hiccups. The patient has no other medical problems.

Expert Solution

(a) A person who has Barrett’s esophagus has a higher risk for cancer because it is a condition that is caused by long-term untreated irritation of the mucosa of the esophagus from gastric and duodenal contents as a result of gastroesophageal reflux disease.
-The erosions in the esophagus destroy healthy tissue and make the area vulnerable to invading abnormal adenocarcinoma cells.

?(b)The cells of the cancerous tumor invade the esophagus and grow in number. The tumor enlarges and obstructs the esophagus to the point where the patient has early symptoms of esophageal cancer.
-The early symptoms include-
dysphagia with solid food
substernal pain
feeling of lump in the throat
Regurgitation
-Later symptoms include difficulty with swallowing liquids, as the mass grows and occludes more of the esophagus. The patient will develop foul breath and hiccups. The patient will have a substantial weight loss and may notice that hemorrhage takes place as the patient regurgitates food or liquids after attempting to eat. The cancer can spread through the mucosal layers of the esophagus and enter the lymphatic system and the cancer can metastasize to the lungs, liver, or kidney.

Nightingale answered 2 years ago

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