Six hours after vomiting heavily following binge drinking after a Cleveland Browns football game, a 34-year-old alcoholic man arrives at the ED with complaints of dysphagia and chest pain. On exam, he is febrile, tachycardic, and normotensive. Esophagography shows contrast material on the left side of the chest at the lower third portion of the esophagus. After fluid resuscitation and antibiotics, the most appropriate next step in management includes

A 72-year-old woman with a history of GERD presents with worsening dysphagia and weight loss. Workup is ordered, including an esophagogram that reveals a distal esophageal mass. An EUS with biopsy confirms the diagnosis of esophageal adenocarcinoma with a T1b lesion. There are no positive lymph nodes, and there is no invasion of surrounding structures. Which of the following is true regarding this lesion?

An 18-year-old man with Prader-Willi syndrome and developmental delay is brought to the ED with abrupt onset pain in the neck. On exam, he is drooling and there is blood-tinged saliva noted. He does not converse at baseline, but his nursing aid noted he had been pointing to the middle of his neck several times and grimacing on the way to the ED. Laboratory studies are unremarkable. The most appropriate initial step in establishing a diagnosis includes

A 65-year-old man presents to the office with difficulty swallowing and a 30-lb weight loss. He has a 45-pack year history of smoking. He undergoes upper endoscopy, and biopsy which is consistent with T2N0 squamous cell cancer 4cm from the upper esophageal sphincter. PET/CT scan demonstrates no metastatic lesions. What is the best definitive therapy?

Which of the following is the proper approach to esophagomyotomy for achalasia?

Which of the following provides the blood supply to the abdominal esophagus?

A 35-year-old man with presents with 6 weeks of burning postprandial epigastric pain that is worse at night, along with daily sour brash. He denies any dysphagia or weight loss. Physical examination shows a soft, nontender abdomen. What is the best next step in management?

A 31-year-old man presents to the ED 1 hour after ingesting a bottle of drain cleaner in a suicide attempt. His pulse rate is 101/min, his blood pressure is 144/78 mm Hg, and his oxygen saturation is 98% on room air. He is complaining of chest pain and nausea. Which of the following is the next best step in the management of this patient?

A 68-year-old man is profoundly acidotic in the SICU after a transhiatal esophagectomy for esophageal cancer. An ischemic gastric conduit is suspected. Which artery is responsible for the blood supply to a gastric conduit after esophagectomy?

A 35-year-old woman presents with a 6-week history of dysphagia. An esophagogram demonstrates a classic bird's beak obstruction. Which of the following is the best treatment for this patient?

Which of the following is true regarding the pressure measurements of the lower esophageal sphincter?

Esophageal motility issues are a common manifestation of scleroderma. Which of the following best describes findings consistent with scleroderma?

A 71-year-old man presents with a 1-month history of progressively worsening dysphagia and a 20-lb weight loss over the past 3 months. He undergoes an upper endoscopy: a 3-cm mass is encountered, with the epicenter of the mass located 1 cm above the GE junction. A biopsy is taken that reveals adenocarcinoma. Further workup with EUS reveals tumor invading the muscularis propria. PET-CT shows no metastatic disease. He is otherwise healthy and exercises 3 times a week. The most appropriate next step in management includes

A 64-year-old man with an esophageal adenocarcinoma of the mid-esophagus is undergoing an esophagogastrectomy. After the tumor is resected and the gastric conduit is made, the anastomosis is ready to be created but, unfortunately, the gastric conduit does not reach the mid-esophagus. What is the next best step in order to create a tension-free anastomosis?

A 34-year-old obese male with a history of asthma presents to the clinic requesting surgery for a 1-year history of heartburn. He denies nausea, dysphagia, or vomiting, but on review of systems, he reports his asthma has worsened over the past 3 months to the point where he is coughing frequently and using his inhaler daily despite no recent allergen exposure. He takes a PPI twice daily. An upper endoscopy performed 6 months ago was unremarkable. The most appropriate next step in management includes

A 55-year-old man presents with a 3-month history of dysphagia and is found to have 4-cm non-circumferential esophageal leiomyoma in the mid-esophagus. Which of the following best describes the appropriate treatment of this patient?

Which of the following findings on biopsy of the distal esophagus confers an increased malignancy risk?

During a transhiatal esophagectomy, as you are dissecting the mid esophagus out of the mediastinum, the anesthesiologist tells you that there is a large air leak and she is having difficulty ventilating the patient. What should you do?

A 35-year-old man presents with complaints of a 2-year history of severe heartburn. He undergoes a trial of proton pump inhibitor (PPI) therapy for 3 months with minimal improvement of his symptoms. He then has 24-hour pH monitoring and manometry. These studies show a percent time of 2.4% of pH less than 4 with normal motility. What is the best next step?