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Heller myotomy is a surgical procedure [1] in which the muscles of the cardia (lower esophageal sphincter or LES) are cut, allowing food and liquids to pass to the stomach.It is used to treat achalasia, a disorder in which the lower esophageal sphincter fails to relax properly, making it difficult for food and liquids to reach the stomach.
Pyloromyotomy is a surgical procedure in which a portion of the muscle fibers of the pyloric muscle are cut. This is typically done in cases where the contents from the stomach are inappropriately stopped by the pyloric muscle, causing the stomach contents to build up in the stomach and unable to be appropriately digested.
Gastric erosion occurs when the mucous membrane lining the stomach becomes inflamed. Specifically, the term "erosion" in this context means damage that is limited to the mucosa, which consists of three distinct layers: the epithelium (in the case of a healthy stomach, this is non-ciliated simple columnar epithelium), the basement membrane, and the lamina propria.
The muscle of the inner layer is arranged in circular rings around the tract, whereas the muscle of the outer layer is arranged longitudinally. The stomach has an extra layer, an inner oblique muscular layer. [1] Between the two muscle layers is the myenteric plexus (Auerbach's plexus). This controls peristalsis.
A Cameron lesion is a linear erosion or ulceration of the mucosal folds lining the stomach where it is constricted by the thoracic diaphragm in persons with large hiatal hernias. [1] The lesions may cause chronic blood loss resulting in iron deficiency anemia ; less often they cause acute bleeding.
Gastric adverse effects may be reduced by taking medications that suppress acid production such as proton pump inhibitors (e.g.: omeprazole and esomeprazole), or by treatment with a drug that mimics prostaglandin in order to restore the lining of the GI tract (e.g.: a prostaglandin analog misoprostol). [40]
The gastric mucosal barrier is the property of the stomach that allows it to safely contain the gastric acid required for digestion. If the barrier is broken, as by acetylsalicylic acid (ASA, aspirin) in acid solution, acid diffuses back into the mucosa where it can cause damage to the stomach itself.
Adverse effects include a transient increase in serum glucose level, and poor wound healing (controversial). Medications include dexamethasone. Butyrophenones are typically administered as a single injection at the end of surgery. Adverse effects include prolongation of the QT interval on EKG. Medications include droperidol and haloperidol.