Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A symptomatic megaesophagus was demonstrated in a three months old boy with Chagas disease. He had a difficult evolution with frequent aspiration pneumonias and progressive undernutrition. At 14 years old a cardiomyotomy (Heller's procedure) was performed, with good results that allowed a near normal life. At 27 years old, the patient started with progressive dysphagia due to an epidermoid esophageal carcinoma and died after surgery. Since a higher frequency of esophageal carcinoma is observed in achalasia, periodic endoscopic examinations are mandatory.
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PMID:[A case of congenital chagasic megaesophagus: evolution until death caused by esophageal neoplasm, at 27 years of age]. 780 23

The postoperative complications of Chagasic megaesophagus were studied in 250 Chagasic patients referred to the Gastroenterology Clinic of Hospital das Clinicas, Federal University of Minas Gerais, Belo Horizonte, Brazil. The treatment was balloon dilatation in 45 (18.0%), myotomy and cardioplasty in 63 (25.2%), Merendino's surgery in 139 (55.6%), esophagogastroplasty in 2 (0.8%) and esophagocoloplasty in 1 (0.4%). There were 125 (50%) early and 30 (12%) late postoperative complications, and in 65 patients (26%) recurrent dysphagia was noted: nineteen (7.6%) after myotomy and cardioplasty, 9 (3.6%) after Merendino's operation and 37 (14.8%) after balloon dilatation. Eighty-five patients (34%) needed reoperations either to correct recurrent dysphagia (56 patients, 22.4%) or to treat other complications (29 patients, 11.6%). The reoperations to correct the 19 recurrences after myotomy and cardioplasty were Merendino's operation (12 patients, 4.8%), forceful dilatation (1 patient, 0.4%), forceful dilatation followed by Merendino's (2 patients, 0.8%), another myotomy (2 patients, 0.8%), myotomy followed by Merendino and balloon dilatation (1 patient, 0.4%) or esophagogastroplasty (1 patient, 0.4%). The recurrences after dilatation were treated by myotomy (15 cases, 6%), Merendino's operation (12 cases, 4.8%) and myotomy followed by Merendino's (3 cases, 1.2%). After Merendino seven reoperations (2.8%) were done: reduction of interposed loop (6 cases, 2.4%) and esophagocoloplasty (1 case, 0.4%). The time elapsed between the first operation and reoperation or dilatation varied from a few weeks to 18 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Postoperative complications in the treatment of chagasic megaesophagus. 835 22

A 23-year-old pregnant woman was found dead at home. The anamnesis was completely negative, except for a slight dysphagia. The most important autopsy finding was a remarkable previously undiagnosed, megaesophagus. Conjunctival and pleural petechiae were also observed. The most likely etiopathogenetic factors are considered and discussed.
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PMID:Achalasia and sudden death: a case report. 858 36

The aim of this paper is to describe a patient with severe postpolio problems who developed achalasia. A 66-year-old patient came to our observation for severe dysphagia. He had suffered from paralytic poliomyelitis at the age of 7 months and had severe residual deficits. At the age of 62 he presented with sudden pain localized in the distribution of the C4 and C5 dermatomes and an inability to abduct the left arm. At the time, he experienced only occasional and mild dysphagia; his esophagus was not dilated and emptied normally. Over the following months his muscular function improved, but dysphagia worsened. We found a megaesophagus with a sigmoid appearance and the manometric features of achalasia. Pneumatic dilatation produced good resolution of dysphagia. A year later manometry showed the reappearance of peristalsis after all wet swallows. In patients with postpolio dysphagia, the possible presence of achalasia must be considered.
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PMID:Achalasia. A possible late cause of postpolio dysphagia. 861 25

Details about the structure of the lower esophageal sphincter and the function of fundoplication are yet unknown. New study is presented about electromanometric examination of the lower esophageal sphincter in 20 chagasic patients with megaesophagus operated on by cardiomyotomy complemented with His angle agudization (Group A-10 patients) or fundoplication (Group B-10 patients). On the 30th postoperative day, the patients, without dysphagia, were submitted to radiologic study, demonstrating valvuloplasty integrity (Group B), and electromanometric study of the esophagus. The comparison between the groups demonstrated: -myotomy does not modify the lower esophageal sphincter extension, but decrease its pressure, not to zero; -fundoplication does not increase the lower esophageal sphincter pressure after myotomy, under resting conditions. These conclusions suggest that: -lower esophageal sphincter is formed by muscular fibers interlacing, configuration that maintains residual regional pressure after myotomy; - in resting state, after myotomy, fundoplication exerts exclusively mechanical function, without increase of the lower esophageal sphincter pressure.
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PMID:[Surgical treatment of megaesophagus. Effect of myotomy and fundoplication on the lower esophageal sphincter]. 876 82

In the present study an attempt was made to analyse from a clinical viewpoint the descriptions in the book "Noticias do que he o achaque do bicho" by Miguel Dias Pimenta (1661-1715), which are considered by some authors to be the first reference to the chagasic megaesophagus and megacolon that appeared in history. In descriptions considered to refer megaesophagus, although dysphagia, the major symptom of this disease, is not recognized, typical manifestations of a irritating, inflammatory or ulcerative condition are identified, not affecting the esophagus but the stomach. In the description considered to refer to megacolon, the signs and symptoms suggest the diagnostic possibility of hemorrhoids and of the "achaque do bicho" itself, and do not recall the clinical picture of the chagasic megacolon in an absolute manner. On this basis, there is no reason to maintain the book "Noticias do que he o achaque do bicho" within the history of the digestive form of Chagas' disease.
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PMID:[Miguel Dias Pimenta (1661-1715) and the history of chagasic megaesophagus and megacolon]. 920 22

A 14-month-old filly with chronic pharyngitis was diagnosed with incomplete esophageal constriction and megaesophagus due to a persistent right aortic arch. This report is unusual because clinical signs of respiratory dysfunction secondary to chronic regurgitation occurred prior to the recognition of dysphagia.
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PMID:Persistent right aortic arch in a yearling horse. 981 40

Leiomyosarcoma constitutes approximately 0.5% of the malignant neoplasias of the esophagus and its association with megaesophagus has not been described. We report on a case of a woman with dysphagia that was slowly progressive from the age of 19 due to chagasic megaesophagus. The woman was subjected to cardiomyotomy at the age of 49. She presented a rapid worsening of the dysphagia due to leiomyosarcoma at the age of 61, and was subjected to subtotal esophagectomy with cervical esophagogastroplasty. She developed pulmonary and hepatic metastases 14 months after surgery and died six months later.
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PMID:Leiomyosarcoma of the esophagus in a patient with chagasic megaesophagus: case report and literature review. 1034 70

As the few randomized controlled trials available in the literature comparing botulinum toxin (BT) injection with established endoscopic treatment of achalasia cardia, i.e. pneumatic dilatation, showed conflicting results, we conducted a prospective randomized trial. Seventeen consecutive patients with achalasia cardia diagnosed during a period between December 1997 and February 2000 were randomized into two treatment groups [pneumatic dilatation by Rigiflex dilator (n=10), BT injection by sclerotherapy needle into four quadrants of lower esophageal sphincter (LES) (n=7) 80 units in five cases, 60 units in two cases] after dysphagia grading, endoscopy, barium esophagogram, and manometry, all of which were repeated 1 week after treatment. Patients were followed up clinically for 35.2+/-14 weeks. Chi-squares, Wilcoxon rank-sum test, Kaplan-Meier method and log-rank tests were used for statistical analysis. After 1 week, 6/7 (86%) BT-treated vs. 8/10 (80%) dilatation-treated patients improved (P=NS). There was no difference in LES pressure and maximum esophageal diameter in the barium esophagogram in the two groups before therapy. Both therapies resulted in significant reduction in LES pressure. The cumulative dysphagia-free state using the Kaplan-Meier method decreased progressively in BT-treated compared with dilatation-treated patients (P=0.027). Two patients with tortuous megaesophagus, one of whom had failed dilatation complicated by perforation previously, improved after BT. One other patient in whom pneumatic dilatation had previously failed improved in a similar manner. BT is as good as pneumatic dilatation in achieving an initial improvement in dysphagia of achalasia cardia. It is also effective in patients with tortuous megaesophagus and previous failed pneumatic dilatation. However, dysphagia often recurs during 1-year follow up.
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PMID:Randomized controlled trial of intrasphincteric botulinum toxin A injection versus balloon dilatation in treatment of achalasia cardia. 1186 25

An undersized, 16-mo-old, captive wood bison (Bison bison athabascae) was observed with dysphagia and postprandial regurgitation. The animal died shortly after anesthesia was initiated for diagnostic purposes. At necropsy, a persistent right aortic arch and aberrant left subclavian artery were diagnosed. The vascular ring structure around the esophagus and the trachea caused a megaesophagus with complete esophageal obstipation and ulcerative esophagitis. The aberrant left subclavian artery did not significantly compromise the esophagus. Persistence of the right aortic arch is relatively rare in ruminants and has not previously been reported in a bison.
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PMID:Persistent right aortic arch in a yearling captive wood bison (Bison bison athabascae). 1256 39


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