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

This is a review of some of the most important growing points in the specialties of gastroenterology and hepatology. It does not aim to be completely comprehensive but to pick out major areas of importance to examination candidates and doctors without special experience in the field. Topics covered include: upper gastrointestinal haemorrhage; Barrett's oesophagus; carcinoma of the oesophagus; achalasia; Helicobacter pylori; duodenal ulcer prevention; coeliac disease; dermatitis herpetiformis; Crohn's disease; small bowel overgrowth; ulcerative colitis; carcinoma of the large bowel; obesity; endoscope sterilisation; gall stones; liver transplantation; autoimmune liver disease; viral hepatitis; metabolic liver diseases; and pancreatic insufficiency.
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PMID:Advances in gastroenterology and hepatology. 1082 44

Calcium concentration in gastric juice is lower then other electrolytes. The mechanism of its transport remained unknown. The aim of the study was to evaluate influence of pentagastrin on calcium concentration in gastric juice in humans. Ten patients were examined (4 females and 6 males, mean age 46.8 range 33-67), four with duodenal ulcer, three with achalasia cardiae and three with Addison-Biermer anemia. Pentagastrin--PG (Cambridge Laboratories, Newcastle, United Kingdom) was injected subcutaneously after overnight fast in dose of 6 micrograms/kg of body weight. Nosogastric tube was located in body of the stomach near large curvature and connected to suction of--40 mmHg pressure. Gastric juice was collected during subsequent five 15 minutes periods (first fasted and four periods after stimulation with PG). Calcium concentration was measured in each sample by fluorescentic titration method with EGTA. Statistic analysis was performed with student "t" test. Mean fasted and stimulated calcium concentrations were 0.83; 0.44; 0.54; 0.37 and 0.95 mmol/l respectively. Ca2+ concentration range in fasted state from 0.21 to 1.75 mmol/l and from 0.07 to 0.27 mmol/l by maximal stimulation. Calcium concentration decreased immediately after stimulation (significance p = 0.0025). This strong effect persisted throughout the period of stimulation. Calcium output was 0.064; 0.029; 0.032; 0.018 and 0.17 mmol/15 min respectively. Two phases of decrease of the calcium output were observed: first, fast decrease immediately after pentagastrin injection and second, slower, between 30 and 45 minute after stimulation (p < 0.01 and 0.02 respectively). Calcium concentration in gastric juice decreases after stimulation with pentagastin (p = 0.0025). Calcium concentration was lower in Addison-Biermer anemia and higher in duodenal ulcer patients then in healthy control. We conclude that calcium ions are not actively secreted by gastric mucosa. Their presence in gastric juice is a result of leak from mucosal cells and remains opposite to their metabolic activity.
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PMID:[The effect of pentagastrin on calcium ion concentration in gastric juice]. 1090 77

We describe a case of pneumopericardium that resulted from esophagopericardial fistula occurring at the 22nd years after operation for achalasia in a 52-year-old male. Atypical features on initial examination suggested myopericarditis or congestive heart failure. A chest roentgenogram and computed tomography revealed development of pneumopericardium. Subsequent emergent pericardiocentesis relieved cardiac tamponade and enabled us to diagnose pyopneumopericardium and esophagopericardial fistula in postoperative period. The esophagopericardial fistula was surgically closed. However, the patient died 2 weeks postoperation of hemorrhage from duodenal ulcer. Autopsy confirmed the pre-mortem diagnosis of esophagopericardial fistula without evidence of malignancy. Early diagnosis and subsequent treatment appears to be most important. This case report reinforces the difficulty of this diagnosis and perhaps the need for clinical awareness and inclusion of this entity in a differential diagnosis.
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PMID:[Esophagopericardial fistula occurring at the 22nd years after operation for achalasia presenting as myopericarditis]. 1188 13

The orderly contractility of the oesophagus and the regulated ability of the pyloric sphincter allow the influx and efflux of gastric contents. When these physiological processes are impaired, gastric luminal transit is altered as expected in achalasia cardia and gastric outlet obstruction. Movement across the inlet and outlet of the stomach is therefore altered. A case of a 58-year old woman diagnosed with simultaneous occurrence of achalasia cardia and gastric outlet stenosis resulting from chronic duodenal ulcer is presented. The diagnosis was based on clinical, radiological and intraoperative findings. This patient has remained well after a simultaneous anterior cardiomyotomy and H-M pyloroplasty. To my knowledge this is the first time that such an association causing gastric "inlet" and "outlet" obstruction has been reported.
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PMID:Achalasia cardia and gastric outlet stenosis in a postmenopausal woman: case report. 1276 34

Surgical treatment was performed in 102 patients suffering duodenal ulcer and chronical calculous cholecystitis, gastroesophageal leyomyoma, esophageal, duodenal, small intestinal diverticulum, cardiospasm and other diseases. In all the patients the simultant operative intervention was performed for duodenal ulcer and other diseases of the abdominal cavity organs. All the patients had survived after the operation. Good and fair results were noted in terms of 6 mo -20 yrs follow-up in 79 patients.
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PMID:[Surgical tactics in the treatment of duodenal ulcer disease coexistent with diseases of other organs of abdominal cavity]. 1711 92


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