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Query: UMLS:C0014848 (achalasia)
 2,804 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cancer excepted all other diseases of the esophagus are rare. Diverticula, benign tumors, perforations and the pathology of the cardia (hiatus hernia, achalasia and esophageal varices) are not studied here. We took into consideration the following diseases only: spasm of the cricopharyngeal muscle, Plummer-Vinson or Kelly-Paterson syndrome, cervical osteophytosis, dysphagia lusoria, benign and malignant mediastinal lymphatic nodes, Schatzki ring of the lower esophagus and esophageal duplications.
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PMID:[Some rare diseases of the esophagus (author's transl)]. 22 8

It is suggested to use the medico-mathematical "decisive rules" for the differential diagnosis of esophageal cancer in non-specialized medical institutions. As the first step the examination cards were written, based on the data of 1195 patients with verified diagnosis. The "decisive rules" were worked out basing on the examination cards of 597 patients (in 267--esophageal cancer and in 330--benign lesions: cardiospasm, benign tumors, cysts, burn and scarring strictures, esophagitis, diverticulum). The suggested "decisive rules" using 63 and 87 clinical signs were tested elsewhere for a retrospective diagnosis in 167 patients. Using the "decisive rules" with 63 clinical signs esophageal cancer was recognized in 96% of cases, non-cancer--in 92%, while using 87 signs--in 92 and 94% accordingly. The rule comprising 63 signs-questions is recommended for practical purposes.
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PMID:[Differential diagnosis of esophageal cancer by using mathematical decision rules]. 38 64

In the light of three cases of esophageal carcinoma developing on a pre-existing idiopathic megaesophagus the authors examine etiopatological, clinical and terapeutic problems related to this association. They believe that carcinoma of the esophagus tends to be a complication of cardiospasm in patients inadequately treated for the primary condition. Early diagnosis and an adequate Heller operation for cardiospasm will lessen the chance of cancer developing in megaesophagus with stasis. When finally diagnosed, this variety of esophageal carcinoma has an extremely poor prognosis. An even more important claim upon the clinician is to be alert to the hazards of continued stasis in megaesophagus and to devise earlier techniques of recognition, including more frequent recourse to biopsy during esophagoscopy.
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PMID:[Association of idiopathic megaesophagus and carcinoma]. 54 Mar 69

The role of fiberendoscopy with regard to various dilatatory procedures is discussed. In particular detailed information is given for dilatation of tight asymmetrical fibrous strictures, with metal olives, for dilatation of advanced achalasia and for dilatation of obstructing gastro-esophageal malignancy, followed by positioning of a plastic prosthesis under endoscopic control.
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PMID:Non-surgical treatment of cardio-esophageal obstruction--role of endoscopy. 59 Feb 11

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

A case of symptomatic esophageal achalasia due to a slowly growing neoplastic infiltration of the esophageal wall by a mammary indifferentiated carcinoma operated ten years before is presented. At admission, the clinical history and the endoscopic appearance of the esophageal lumen and mucosa led to the diagnosis of idiopathic achalasia, while the esophageal manometry showed a rather long high pressure zone (6--8 cm), which did not relax with deglutition. Barium study confirmed the length of the achalasic tract. Only thoracotomy permitted a correct diagnosis. On the basis of this case achalasia is thus considered as a syndrome which can be either idiopathic or secondary to Trypanosoma cruzi, high troncular vagotomy, benign or malignant tumor infiltrating the esophageal wall. The difficult diagnosis of some cases from the clinical point of view is underlined. Stress is laid on the necessity that all findings (history, radiology, endoscopy, manometry) be carefully evaluated to reach a preoperative diagnosis.
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PMID:[Achalasia caused by infiltrating carcinoma of the esophagus. Clinical case and physiopathological considerations]. 69 94

1. Esophageal achalasia is a rare disease of unknown origin that occurs with the same frequency in both sexes. 2. During the preoperative workup as well as the postoperative time the following studies should be performed: upper GI series, esophageal manometry and endoscopy with biopsy. 3. In most instances conservative treatment with dilations only provides temporal relief of the symptoms and moreover, is not exempt from complications; it should be employed only in incipient achalasia, in patients who refuse to be operated upon and in those whose general conditions make surgery inadvisable. 4. Surgery can provide a permanent cure for the symptomatology in the majority of the patients, with a very low mortality and morbidity; an operation should be performed early in those who retain more than 10 mls. in the esophagus with persistence of the symptomatology as well as in those patients in whom cancer is suspected. 5. A modified Heller type operation, with abdominal approach with gastrostomy, diaphragmatic hernioplasty and an anti-reflux procedure and when necessary a piloroplasty is the treatment of choice for esophageal achalasia yielding good results in 88.8% of the cases. It should be noted that the degree of postoperative gastroesophageal regurgitation is directly related to the extent to which the gastric incisons is extended below the esophageal-gastric junction.
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PMID:[Surgical treatment of achalasia. Analysis of 27 cases]. 71 47

In the last 6 years 16 patients with an iatrogenic esophageal lesion have been treated. Most frequently this lesion results from esophagoscopies and bouginages. Laying of a gastric tube, extraction of a foreign body or dilatation of a cardiospasm are rare reasons for a lesion. Only three patients suffered from cancer. The early diagnosis and immediately operation is decisive for the therapy's success. The operation with primary closure of the defect and drainage should be aspired. After this the best results are levelled. If the surgical operation is carried on after the 24-hours limit, the operation itself is of minor importance as the lethality of these patients is very high and does not depend on the kind of therapy.
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PMID:[Instrumental esophageal perforations--diagnosis and treatment (author's transl)]. 83 28

The results from the 195 performed fibroesophagoscopies and 114 purposeful biopsies in different esophgus diseases are reported. In 65 of the examined -- cancer of the esophagus or cardia ventriculi was establised. The rest 122 patients are with non-malignant disease -- ulcers, polyps, diverticulums, varices, strictures, esophagitis, cardiospasm, etc. Cancer of esophagus and cardia ventriculi is proved in 93.93 per cent on the base of endoscopic data while another diagnosis was given in 29.30 per cent at the X-ray examinations of the same patients and at the clinical examinations of the patients in 40.1 per cent -- diagnostic errors were made. The purposeful biopsy gives 70.58 per cent of positive results and enables the differentiation of the tumor histological characterisitics.
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PMID:[Diagnostic possibilities of fibroesophagoscopy and target biopsy of the esophagus]. 122 12

In a follow-up study of 147 patients with achalasia of the esophagus treated by myotomy, 146 patients were traced (58 female and 88 male patients aged 4 to 83 years [median, 46 years]). The living persons were contacted in writing or by telephone. The mean follow-up time after the operation was 23.2 years (range, 6 to 41 years). The cause of death was established for 71 patients. There were three postoperative deaths and two deaths following recurrence. In comparison with the Danish population, the 66 remaining patients were found to have a relatively higher cancer mortality (33.8 percent). Contrary to the expected less than one, ten of 23 patients who died of cancer had a malignant tumor in the esophagus. The mortality rate after 30 years was 66.1 percent, 11.9 percent of the deaths caused by esophageal cancer. It is concluded that there is a connection between achalasia and cancer of the esophagus that ought to be considered in the treatment and follow-up of patients with achalasia.
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PMID:Does achalasia predispose to cancer of the esophagus? 139 35


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