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

Six new instances of primary cricopharyngeal achalasia are reported. Since 1961, treatment of these as well as eight other cases of sphincter dysfunction with secondary pharyngoesophageal diverticulum has consisted of posterior division of the muscle and inversion rather than excision of the diverticulum. The validity of this approach is supported by restoration to normal or near normal swallowing based on clinical and cineradiographic evidence. The advantages of performing this surgery under local anesthesia include the opportunity to observe directly the pathophysiology of the swallowing disorder, precise division of the cricopharyngeus muscle, and the ability of this older group of patients to eat, drink, and function normally immediately after operation.
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PMID:Surgery for cricopharyngeal dysfunction under local anesthesia. 81 15

A patient with complete esophageal obstruction from cricopharyngeal achalasia in whom adequate cricopharyngeal myotomy failed to alleviate the dysphagia is described. The importance of pre-operative radiological evaluation of patients with neurologically related dysphagia is discussed, specifically, the degree of obstruction, range of tongue movement, and presence of aspiration. These factors have a predictive value in assessing the benefits of planned cricopharyngeal myotomy.
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PMID:Complete esophageal obstruction from cricopharyngeal achalasia. 84 87

A case of congenital suprabulbar paresis is reported. The associated severe dysphagia which presented soon after birth was shown by radiographic and cineradiographic studies to be due to cricopharyngeal achalasia. During four years of follow-up a clear tendency to spontaneous improvement was seen. It is therefore suggested that the condition may have a favorable outcome without resorting to surgical intervention.
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PMID:Cricopharyngeal achalasia associated with congenital suprabulbar paresis. 97 77

A survey of 108 patients with achalasia treated by cardiomyotomy is reported. All the operations were done by the abdominal approach and all the patients were followed up for a minimum of 4 years. Fifty-five patients had some form of hiatal reconstruction, 11 of these having a formal plastic repair as practised for oesophageal reflux problems. At 4 years after operation 71 patients (65-5 per cent) had entirely satisfactory results. Twenty-seven patients had recurrent dysphagia and 20 patients had symptoms of reflux oesophagitis. The group who had had a formal repair of the hiatus had no reflux symptoms after operation and also had better swallowing than the other groups. These results suggest that much of the dysphagia following Heller's operation is due to occult gastro-oesophageal reflux and can be avoided by a reflux-preventing procedure. Adequate hiatal repair after myotomy is strongly recommended.
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PMID:Results of Heller's operation for achalasia of the oesophagus. The importance of hiatal repair. 100 44

A case of diffuse leiomyomatosis of the esophagus in a 21-year-old woman with a 5-year history of dysphagia is presented. The radiological appearance was that of achalasia, but at esophagoscopy, a diagnosis of an organic stricture of the lower end of the esophagus was made. During the operation a diffuse tumor involving the lower end of the esophagus, cardia, upper portion of the stomach, and the tail of the pancreas was found. The histological diagnosis was diffuse leiomyomatosis of the esophagus. The individual characteristics of the microscopic picture are described. Distal esophagectomy and total gastrectomy resulted in complete recovery of the patient. This is a very rare condition; only a dozen similar cases have been published before. The data of these patients are presented.
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PMID:Diffuse leiomyomatosis of the esophagus: a case report and review of the literature. 114 92

56 patients with achalasia of the esophagus were reviewed in a retrospective study to compare the results of a forceful pneumatic dilation with those of a Heller esophagomyotomy. 22 of 33 patients treated with forceful dilation (67%), showed relief of dysphagia and reduction in the average esophageal diameter by barium swallow during the follow-up period (mean = 6.5 years). In 2 patients (6%), forceful dilation was complicated by esophageal perforation, promptly diagnosed, and successfully treated at surgery in both patients. 21 out of 23 patients who underwent esophagomyotomy (91%) showed permanent relief of symptoms and improvement by endoscopic and radiographic criteria. There were no significant postoperative complications during the follow-up period ranging between 1.5 and 10.0 years. The results of this study indicate that esophagomyotomy constitutes a more effective therapeutic modality than forceful dilation (P less than 0.05). Although esophageal dilation has a place in the treatment of early achalasia, esophagomyotomy appears to be a safer and a more successful form of treatment, of particular value in advanced esophageal disease and in those instances where pneumatic dilation fails to result in immediate clinical improvement.
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PMID:Achalasia of the esophagus. A reappraisal of esophagomyotomy vs forceful pneumatic dilation. 116 19

Deglutition is a complex neuromuscular act. Alterations in anatomy and physiology may lead to dysphagia. The role of the cricopharyngeus appears to be the keystone in the rehabilitation of many patients with dysphagia. This paper examines the physiology of swallowing as well as the patho-physiology of its abberations. Techniques and complications of cricopharyngeal myotomy are presented. Cases of dysphagia due to ablative surgery of the head and neck, dermatomyositis, cerebrovascular accidents, and cricopharyngeal achalasia in which cricopharyngeal myotomy was utilized, are reported. It would appear from this small number of cases, that cricopharyngeal myotomy is indicated in the rehabilitation of dysphagia in patients with varied disease states.
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PMID:Cricopharyngeal myotomy in the treatment of dysphagia. 119 69

Inclusion body myositis is an inflammatory myopathy in which dysphagia has been considered a rare finding. However, recent literature finds dysphagia an increasingly common symptom as more cases of inclusion body myositis are identified. Unlike some inflammatory myopathic disorders, inclusion body myositis is resistant to treatment with corticosteroids, and therefore, the otolaryngologist may be consulted regarding surgical options for relief of dysphagia. A patient is described in whom severe progressive dysphagia associated with inclusion body myositis developed. Impaired pharyngeal wall motion and cricopharyngeal achalasia were demonstrated by videofluoroscopic evaluation, and the patient was successfully treated by cricopharyngeal myotomy. The pathophysiologic nature of inclusion body myositis and the mechanisms of cervical dysphagia in the inflammatory myopathies are reviewed.
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PMID:Management of dysphagia in inclusion body myositis. 131 47

Achalasia is believed to be a predisposing factor for the development of esophageal cancer. Small cell carcinoma of the esophagus is a rare neoplasm, with fewer than 150 cases having been reported in the world literature, and it has been described only once previously in a patient with longstanding achalasia. We describe a case of an 85-yr-old woman with long-term primary achalasia who developed primary small cell carcinoma of the esophagus. We hypothesize that this patient's recurrent, worsening dysphagia is related to a paraneoplastic phenomenon. We discuss this association and review the literature.
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PMID:Small cell carcinoma of the esophagus in a patient with longstanding primary achalasia. 131 72

With the increasing availability of manometry, patients with achalasia are often referred at an early stage when they lack the classic features of established disease. A prospective five year study of the presenting features of untreated achalasia referred to our department was undertaken. Twenty men and 18 women presented throughout adult life, with a mean age at the time of diagnosis of 44 years (range 17 to 76 years). The presenting symptoms were dysphagia: for solids (100%) and for liquids (97%), chest pain (74%), and weight loss (60%). Endoscopy was reported as normal in 15 patients and achalasia was suggested in only 21 of 33 barium examinations. Fourteen had been treated for gastrooesophageal reflux but none had been misdiagnosed as having cardiac or psychiatric disease. The annual incidence of achalasia in the Lothian region is 0.8/100,000 of population. Persistent dysphagia is the cardinal symptom of achalasia which presents throughout adult life. Nevertheless, recent onset achalasia is often misdiagnosed as gastrooesophageal reflux disease. Because endoscopy is frequently normal and the diagnosis is often not made by radiology, manometric investigation is necessary if the condition is to be recognised and treated at an early stage.
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PMID:Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh. 139 23


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