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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An operation employing the Nissen fundoplication performed about an undivided 5 cm gastroplasty tube created with a gastrointestinal anastomosing (GIA) stapler that was modified by elimination of the cutting blade has been devised and evaluated in 48 patients over a period ranging from 3 to 52 months (average, 27 months). Seventeen of these patients had severe esophageal strictures. Reflux control, evaluated by clinical appraisal and roentgenograms in all patients and by 24-hour esophageal pH monitoring in some, has been complete in all patients throughout the study. One patient with undetected subclinical achalasia continues to have mild dysphagia and represents the only unsatisfactory result in the series. Normal swallowing has been restored to all patients with strictures, and the others remain free of symptoms. The simplicity, reproducibility, and effectiveness of this operation warrant its continuing evaluation.
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PMID:The modified Collis-Nissen operation for control of gastroesophageal reflux. 66 22

A survey of 102 patients with achalasia of the cardia treated by cardiomyotomy is reported. The technique of operation was unchanged throughout and the patients were followed up for a maximum of 22 years. Only 6 patients (5.8 per cent) developed renewed symptoms of reflux and 7 patients (6.8 per cent) had peptic strictures. Over 80 per cent of the patients had no dysphagia or regurgitation postoperatively, but 61 per cent still complained of achalasic pain. The development of mucosal hernias after cardiomyotomy and the use of drinking times in the assessment of outflow at the cardia are discussed.
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PMID:Results of Heller's operation for achalasia of the cardia. 66 43

Functional disroders are the most important cause for complaints in the gastrointestinal tract. Dysfunction may concern one or more physiologic properties like tonus, motility, secretion, sometimes also resorption and digestion, or their interaction. Functional disorders of the esophagus (esophagospasm and achalasia) become manifest as dysphagia. Halitosis, bad taste, burning tongue, and flatulent abdomen are frequent symptoms of functional disorders of the gastrointestinal tract. Irritable bowel syndrome is probably the functional disorder most freqently found in the gastrointestinal tract. Characteristic symptoms are pain in the lower and upper middle abdominal region, obstipation and/or diarrhea, flatulent abdomen, mucous discharge with the stools and urgent defecation with cramps relieved after discharge. Prognosis quoad vitam is good, the course, however, is subject to many changes. Therapie is symptomatic. Diagnostic and psychotherapeutic measures are intended to help remove carcinophobia and to overcome conflicts and fears.
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PMID:[Functional disorders of the gastrointestinal tract (author's transl)]. 68 14

The clinical and diagnostic features of a secondary type of achalasia of the esophagus are described in seven patients with various types of malignancies. Patients with secondary achalasia presented with dysphagia of short duration and marked weight loss; mean age was 64 years. Esophageal manometry showed features identical to those of idiopathic primary achalasia: aperistalsis, poor lower esophageal sphincter relaxation, and elevated sphincter pressure. Endoscopy and barium swallow showed evidence of a tumor in only two cases. Various types of malignancies may produce a secondary form of achalasia that has diagnostic features identical to those of primary achalasia and is best identified by its clinical presentation.
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PMID:Achalasia secondary to carcinoma: manometric and clinical features. 68 41

Most operations performed for peptic ulcer disease in the United States include vagotomy as part of the surgical procedure. This paper reviews the complications associated specifically with or increased in frequency and severity by this procedure. Included in this review are technical complications, gastric retention, recurrent ulceration, postvagotomy diarrhea, postvagotomy dysphagia and achalasia, postvagotomy biliary disease and nutritional problems. The frequency of these complications, their pathophysiology and therapeutic modalities available are reviewed. The main emphasis is on postvagotomy syndrome that can be treated medically and on the various treatment forms that have been suggested.
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PMID:Complications of vagotomy. 69 13

A prospective study of 595 patients treated by the Thoracic Surgical Unit (TSU) at the University College Hospital (UCH), Ibadan between July 1975 and December 1977 was carried out to determine the pattern of thoracic surgical diseases in Nigeria and to prove or disprove the rarity of certain cardiopulmonary diseases in tropical Africa. This review shows that pyogenic infections of the lung and pleura constitute the largest percentage (38.5) of the thoracic surgical diseases in Nigeria. Although pulmonary tuberculosis accounts for only 23.4 percent of our total inpatient load, it constitutes about 60 percent of our outpatient clinic practice. Cardiovascular diseases form 12.9 percent, notably congenital and acquired valvular heart diseases. An interesting finding was the occasional association of pyomyositis with pyogenic pericarditis and empyema thoracis. This triad is being investigated. Chest trauma was the most common thoracic surgical emergency accounting for 9.2 percent of the total thoracic surgical pathology. The most common causes of dysphagia are strictures from corrosive esophagitis, achalasia, and carcinoma of the esophagus. Present experience confirms the rarity of hiatus hernia, reflux esophagitis, atherosclerotic cardiovascular disease, and, perhaps, carcinoma of the lung among Nigerians.
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PMID:Pattern of thoracic surgical diseases in Nigeria: experience at the University College Hospital, Ibadan. 70 99

Achalasia is a neuromuscular functional disturbance with dystonia and dyscinesia of the entire tubular oesophagus of unknown aetiology characterised by loss of cardial opening reflex. In the usual functional state dysphagia and moderate stenosis are observed, but occasionally an organic form with marked mega-dolicho-oesophagus will develop. Therapeutically an attempt is made to reduce the hypertonus of the terminal oesophagus. In mild or moderate cases this may be achieved by dilatation alone. If conservative treatment fails or in severe forms an operative correction is mandatory, we advise preoperative dilatation together with an extramucous myotomy of the distal anterior oesophageal wall and a fundoplication to prevent the gastro-oesophageal reflux. This abdominal procedure demands great care but is not traumatising and ensures satisfactory early and late results even in patients with considerable surgical risks. Operative indication and technique in 63 cases are demonstrated.
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PMID:[Achalasia of the oesophagus. Operative treatment by abdominal myotomy and fundoplication (author's transl)]. 71 70

Achalasia has not been previously reported in father and son. A man, age 38, and his father, age 66, presented two years apart with symptoms of dysphagia and aspiration. The diagnosis of achalasia was made on the basis of x-ray and endoscopic findings and on esophageal motility studies performed on the father. Both responded well to pneumatic dilatation and have been asymptomatic for 24 months and 6 months, respectively. These cases again suggest a genetic basis for achalasia.
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PMID:Achalasia in father and son. 71 60

Achalasia of the cardia frequently presents as dysphagia in middle age. In the elderly, dysphagia is usually due to a neoplasm of the oesophagus or cardia. The authors have been interested to see five patients over the age of 70 presenting with oesophageal symptoms due to achalasia which is uncommon in this age group and may be mistaken for neoplastic disease.
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PMID:Achalasia of the cardia in elderly patients. 73 85

A case of dysfunctioning of the oesophageal opening is reported. The patient, aged 71 years, had had difficulty in swallowing for a long time, complicated by the recent onset of obvious dysphagia. Radiological examination of the oesophagus revealed the presence of a permanent notch in the posterior wall in the crico-pharyngeal region. The endoscope could not pass through the oesophageal opening but radiocinematography did not reveal any obvious organic lesion. The dysphagia and crico-pharyngeal notch disappeared after myotomy. This case is one the rare examples of pharyngo-oesophageal incoordination wrongly called crico-pharyngeal achalasia, as there does not appear to be any disorder of relaxation of the upper oesophageal sphincter, and this was demonstrated by the postoperative manometric study carried out in our patient.
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PMID:[A case of dysphagia due to dyskinesia of the oesophageal opening (author's transl)]. 74 89


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