Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0014848 (achalasia)
 2,804 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with a "thoracic succussion splash" due to achalasia is described. She noted a splashing or sloshing sensation in her chest related to jogging and bending. On examination a splashing sound could be heard over the mid sternum and the posterior chest when the patient was rocked vigorously back and forth.
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PMID:Thoracic succussion splash: a new symptom and sign of achalasia. 226 44

A 12-year-old girl presented with cough, emesis, and weight loss of 18-month duration. She was diagnosed as having achalasia of the esophagogastric junction. Flow-volume loops done because of the cough revealed a configuration consistent with variable intrathoracic tracheal obstruction. A barium swallow revealed the cause of obstruction to be massive dilatation of the esophagus. Balloon dilatation of the esophageal sphincter resolved all symptoms and normalized the flow-volume loops. This case illustrates that some pulmonary symptoms in achalasia can be due to direct tracheal obstruction in addition to the usual aspiration of esophageal contents.
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PMID:Tracheal obstruction secondary to esophageal achalasia. 318 82

We described an 84-year-old woman with symptomatic achalasia who refused both dilation and surgical treatment. She was treated with the calcium channel blocking drug nifedipine, with significant relief of symptoms. Objective evidence of response to the drug was confirmed by using an egg salad sandwich meal labeled with 99mTc-DTPA.
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PMID:Nifedipine for the poor-risk elderly patient with achalasia: objective response demonstrated by solid meal study. 636 79

A 17-year-old female complained of difficulty swallowing and recurrent vomiting of one year duration. She stated that she was trying to gain weight. She felt that a weight at the 5th percentile for age was appropriate for her 70th percentile height. She denied binge eating, self-induced vomiting, concern over abnormal eating, or depressed mood. She had low normal intelligence, long-standing problems with school and peer relationships, and was experiencing significant conflict with her stepfather. The mother noted that her daughter's symptoms had begun at the time her prized horse went lame. Physical examination was unremarkable except for thinness. At a two-week follow-up visit, all vomiting had ceased and the patient had gained 1.6 kg. Plans for a barium esophagogram were cancelled and psychiatric consultation was arranged. A six-week followup revealed no vomiting, although weight gain had not progressed. Six months later, the patient was seen with a two-month history of recurrent vomiting. A barium esophagogram revealed achalasia. Pneumatic dilation of the lower esophageal sphincter was successful. Seventeen months after the initial visit the patient was asymptomatic, happy, and seemingly well adjusted.
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PMID:An adolescent with vomiting and weight loss. 649 Apr 83

An infant with cricopharyngeal achalasia, recurrent aspiration pneumonia, and severe failure to thrive was fed for 5 months through a nasogastric tube. She responded promptly to dilatations of the spastic cricopharyngeal muscle. Normal oral feedings followed the treatment with progressive weight gain and no further pulmonary complications over a follow-up period of 1 1/2 years. Dilatations were used in the infant described here, in analogy to the well-known success of treatment by dilatations in infants with achalasia of the lower esophagus.
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PMID:Congenital cricopharyngeal achalasia treatment by dilatations. 672 83

Acute airway obstruction associated with esophageal achalasia is an uncommon but life-threatening complication. The pathophysiology of this phenomenon has not been fully defined. A fully documented case of coexistent esophageal achalasia and upper esophageal sphincter relaxation abnormality presenting with airway obstruction is reported. The patient was initially treated with Heller's myotomy but had a recurrence of respiratory distress. She was successfully treated by cricopharyngeal myotomy. The causes of gas entrapment and respiratory distress are likely to be due to failure of both swallow- and distention-induced upper esophageal sphincter relaxation. Cricopharyngeal myotomy is an effective treatment for this complication, probably by facilitating esophagopharyngeal gas venting.
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PMID:Esophageal achalasia and coexistent upper esophageal sphincter relaxation disorder presenting with airway obstruction. 755 3

A 65-year-old woman was admitted to our hospital because of pulmonary nodules, about 3 cm in diameter in the right upper lobe accompanied by pleural indentation, and 5 mm in diameter in the left middle lung field, revealed by chest X-ray. She had no clinical signs or symptoms except achalasia-like discomfort swallowing. Results of physical examinations were within normal limits. A specimen obtained from the nodule in right S2 by transbronchial biopsy showed noncaseating epithelioid granuloma containing asteroid bodies, and negative staining for acid-fast bacilli. No malignant cells were found in the specimen. Bacteriological examination of a bronchial lavage specimen was negative for pyogenic bacteria, mycobacteria and fungi. A PPD skin test was negative. BALF revealed an increase of lymphocytes and elevation of CD4/CD8 ratio. Fifteen years previously, the patient had been diagnosed as having sarcoidosis by scalene node biopsy, and had been treated with steroid therapy. Pulmonary nodules associated with pleural indentation in sarcoidosis is relatively rare, and is usually due to malignancy such as lung cancer. This possibility was ruled out clinically in the present case. Therefore, it was concluded that the pulmonary nodules in this case were due to the sarcoidosis itself.
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PMID:[A case of sarcoidosis presenting as pulmonary nodules associated with pleural indentation fifteen years after onset]. 827 63

We report the case of a 74-year-old woman who presented with a 2-year history of dysphagia, weight loss, nausea, and vomiting. She was diagnosed as having secondary achalasia due to external compression probably by a tumor of the lower part of the esophagus. At autopsy, however, no tumor was found at that site, whereas a pancreatic microcystic serous adenoma and multiple gastric leiomyomata--one of which occupied the pyloric sphincter area leading to gastric outlet obstruction--were noted. The esophagus displayed two fusiform dilatations located at the lower and midportions, the latter being associated with rupture and necrosis of the muscularis and adventitial wall layers. The lower dilatation showed only attenuation of the muscularis, without necrosis. The epithelium was intact in both dilatations. This was an unusual series of pathogenetic events, leading from gastric outlet obstruction to secondary achalasia and protracted vomiting, followed by spontaneous partial esophageal wall rupture (a variant of intramural hematoma) or atrophy of the muscularis, morphologically evident as fusiform dilatations.
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PMID:Fusiform dilatations of the esophagus secondary to protracted distention and emetogenic injury. 834 53

We report a case of giant epiphrenic diverticulum in a 43-year-old woman who underwent Heller's myotomy because of achalasia 20 years earlier. She complained of heartburn and dysphagia from March of 1991 and was hospitalized in our institution. An upper gastrointestinal X-ray examination with contrast medium revealed a large hemispheric lesion (7.8 x 4.8 cm) occupying the right posterior wall of the lower thoracic and abdominal esophagus. Manometry revealed a motility disorder and high pressure of the lower esophageal sphincter due to achalasia. Therefore she was diagnosed as having a giant diverticulum with achalasia after Heller's operation. She underwent transhiatal esophagectomy and reconstruction with placement of a gastric tube on June 4, 1992. Pathology results on the resected specimen revealed a false diverticulum. She has been doing well for 4 years since the operation. It has been said that a complication of incomplete long myotomy causes pulsion diverticulum, but we could not find a case of epiphrenic diverticulum after myotomy for achalasia reported in the literature in the last 10 years.
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PMID:Giant epiphrenic diverticulum with achalasia occurring 20 years after Heller's operation. 902 49

We report a woman with achalasia cardia who developed dysphagia for the first time during pregnancy. She was initially mistakenly treated elsewhere as hyperemesis gravidarum. The diagnosis and treatment of achalasia during pregnancy is reviewed.
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PMID:Esophageal achalasia presenting during pregnancy. 911 83


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