Barrett’s Oesophagus – an important topic, particularly for those preparing for their FRCS exams I’m your host, Major Munish Chauhan, and I am a General Surgery Registrar in the British Army and Oxford deanery. I am also a Senior Research Fellow at the Centre for Army Leadership

Barrett's oesophagus is a precancerous condition where the lining of the lower oesophagus changes, primarily due to long-term gastro-oesophageal reflux disease (GORD).

This change, called intestinal metaplasia, increases the risk of developing oesophageal adenocarcinoma. Diagnosis involves endoscopy and biopsies, with severity graded by dysplasia. Treatment options range from medication and endoscopic therapies (such as radiofrequency ablation) to surgery (esophagectomy), depending on the stage and severity of the condition. Regular surveillance is crucial for early detection and management, improving prognosis and reducing mortality. Risk factors include male gender, age, obesity, and smoking.

Oesophageal Perforation and Rupture -MRCS FRCS Exam

This podcast episode from SurgiSmart - Cut to the Core provides a comprehensive overview of oesophageal perforation and rupture. I’m your host, Major Munish Chauhan, and I am a General Surgery Registrar in the British Army.

The episode details the causes, including Boerhaave's syndrome and iatrogenic events, alongside the characteristic clinical presentation, such as severe chest pain and subcutaneous emphysema. Diagnostic approaches, utilising CT scans and endoscopy, are explained, followed by a discussion of management strategies, ranging from conservative treatment to surgical intervention and stenting. Finally, the episode highlights potential complications and the importance of prompt diagnosis and treatment for improved patient outcomes.

Oesophageal Diverticula - MRCS FRCS Exam

This podcast episode from SurgiSmart – Cut to the Core provides a structured overview of oesophageal diverticula for surgical trainees.

I’m your host, Major Munish Chauhan, a General Surgery Registrar in the British Army and Oxford deanery. Alongside my clinical practice, I’m a Senior Research Fellow at the Centre for Army Leadership

It details the three main types – Zenker’s, mid-oesophageal, and epiphrenic – explaining their differing presentations, aetiologies, diagnostic approaches (including barium swallow studies and endoscopy), and surgical management options (ranging from endoscopic techniques to open surgery).

The episode emphasises the importance of addressing underlying motility disorders where relevant and highlights the nuanced considerations for each diverticular type. The discussion is tailored to aid exam preparation for the FRCS in General Surgery.

In this episode, we’ll delve into oesophageal motility disorders, an essential topic for any surgical trainee, particularly those preparing for the FRCS exam.

Today’s discussion will focus on:

• Achalasia

• Diffuse oesophageal spasm and hypercontractile oesophagus

• Scleroderma-related oesophageal dysmotility

We’ll explore their pathophysiology, diagnosis, and management in detail to ensure a comprehensive understanding.

Welcome back to SurgiSmart - Cut to the Core!

I’m your host, Major Munish Chauhan, General Surgery Registrar in the British Army and Oxford Deanery. I’m also a Senior Research Fellow at the Centre for Army Leadership, where I focus on self-leadership, resilience, and metacognition.

Welcome back to SurgiSmart - Cut to the Core podcast, where we break down essential surgical topics to help you understand surgical conditions. I’m your host, Major Munish Chauhan, and I am a General Surgery Registrar in the British Army and Oxford Deanery. I am also a Senior Research Fellow at the Centre for Army Leadership, where I research, write, and deliver presentations on leadership domains such as self-leadership, resilience, metacognition, cultural diversity, and psychological safety.

Today, we’ll be discussing Hiatal Hernias—a common condition in general surgery that presents with a range of symptoms and has specific management guidelines. Let’s cut to the core of this topic.”

Hiatal Hernias, focusing on their anatomy, physiology, pathology, diagnosis, and management based on the latest NICE guidelines. So, what exactly is a hiatal hernia? A hiatal hernia occurs when part of the stomach protrudes through the diaphragm into the chest cavity, disrupting the normal anatomy and function of the upper gastrointestinal tract. This can lead to a range of symptoms, from acid reflux to chest pain, and sometimes even more serious complications if left untreated.

There are two main types of hiatal hernias that are important to differentiate: sliding and paraoesophageal hernias.

• Sliding hiatal hernias are the most common type. In these, the gastro-oesophageal junction and part of the stomach slide upwards through the diaphragm. This is often associated with gastroesophageal reflux disease (GERD), leading to symptoms like heartburn, regurgitation, and chest discomfort.

• Paraoesophageal hiatal hernias, on the other hand, are less common but more dangerous. In this type, part of the stomach bulges through the diaphragm beside the oesophagus, potentially causing severe complications like gastric volvulus or strangulation, which can compromise the blood supply to the stomach and become life-threatening.

FRCS Exam - Gastro-Oesophageal Reflux Disease, or GORD, a condition that’s not only a frequent topic in the FRCS exam but also a significant clinical issue affecting millions worldwide. We’ll explore the key aspects of GORD, from understanding its underlying mechanisms and recognising its varied presentations to diagnosing it accurately and managing it effectively.

FRCS Exam - Anatomy and physiology of the oesophagus, providing a solid foundation for understanding its function and the diseases that affect it.