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

With the use of gastroesophageal withdrawal pH curve, pathophysiology after various surgical procedures for achalasia of the esophagus was investigated experimentally from the view point of postoperative reflux. A total of 68 dogs were divided into four groups and were prepared with proximal gastrectomy with end-to-end esophagogastrostomy, Wendel procedure, Heller procedure and Fundic patch operation, respectively. In the group with Fundic patch operation, efficacy of the flap valve, mucosal valve and fundoplication was also evaluated preparing them in various sizes. The results obtained may be summarized as follows: 1) Withdrawal pH measurement is a sentive mean to detect the gastroesophageal reflux. 2) Proximal gastrectomy with end-to-end esophagogastrostomy and Wendel procedure yielded worst results with severe gastroesophageal reflux. On the contrary, Fundic patch operation best controlled the gastroesophageal reflux. 3) Gastroesophageal reflux could be prevented by the Fundic patch operation with the flap valve 6 cm in length and fundoplication enclosing around 1/2 to 2/3 circumference of the distal esophagus.
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PMID:[Evaluation of antireflux effect of fundic patch operation by withdrawal pH curve (author's transl)]. 2 21

The lower esophageal sphincter pressure has been measured intraoperatively in 200 patients with gastroesophageal reflux and in three patients with achalasia. Lower esophageal sphincter pressure is measured before and during repair. Calibrating the cardia during performance of the median arcuate posterior gastropexy allows a sphincter pressure between 50 and 57 mm. Hg to be obtained at operation. The postoperative pressures have ranged between 15 and 25 mm. Hg, or approximately half of the intraoperative pressure. No patient with a spincter pressure of 15 mm. Hg or greater has reflux according to postoperative pH and pressure studies. Correction of reflux correlates well with relief of symptoms. Three patients with achalasia had intraoperative manometrics during myotomy. The lower esophageal sphincter pressure was lowered and the length of the lower esophageal sphincter was shortened. Dysphagia was corrected without producing reflux. This is the first report of measurement of lower esophageal sphincter pressure in anesthetized patients. Intraoperative measurement of sphincter pressure is a safe, simple, and reliable technique which allows the surgeon, for the first time, to determine the status of the lower esophageal sphincter during the operation. This technique should be standard for all operations on the gastroesophageal junction.
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PMID:Intraoperative measurement of lower esophageal spincter pressure. 2 82

We report the illness of a 32-year-old male with the syndrome of multiple endocrine neoplasia, type 2b, which comprises medullary carcinoma of the thyroid, phaeochromocytoma, oral mucosal neuromas and skeletal deformity. The patient also had evidence of ganglioneuromatosis of the alimentary tract, a finding which is held to be responsible for constipation and a number of the other gastrointestinal manifestations of the MEN, 2b. Dysphagia, which has not been previously reported in the syndrome was also present. Investigations of the oesophagus which included endoscopy, radiology and a motility study support the diagnosis of achalasia as the cause of the dysphagia.
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PMID:Colonic and oesophageal disturbance in a patient with multiple endocrine neoplasia, type 2b. 3 47

Isolated glucocorticoid failure associated with achalasia of the cardia is described in two pairs of siblings in separate families. Defective tear production is also present in three of the patients, and one shows other signs of autonomic dysfunction. Two other families with adrenal insufficiency and achalasia are known. This unusual association probably represents a familial disorder of as yet unknown aetiology.
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PMID:Familial glucocorticoid deficiency with achalasia of the cardia and deficient tear production. 7 49

ECG was recorded in 38 patients with achalasia of the esophagus before, during and after pneumatic dilatation. During the dilatation both marked increases as well as decreases of heart frequency were observed. The mean values of all patients remained virtually unchanged. The most frequent type of arrhythmia were ventricular extrasystolies (16 patients), whereas supraventricular extrasystolies (4 patients), second degree-av-block (2 patients) and av-dissociation (1 patient) occured infrequently. In none of our patients arrhythmia was critical, even in a patient with preexisting cardiac insufficiency. Thus, patients with achalasia of the esophagus are not endangered to a major degree by cardiac arrhythmia during pneumatic dilatation.
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PMID:[Cardiac arrhythmia during pneumatic dilatation of achalasia of the esophagus (author's transl)]. 7 69

Between 1949 and 1976, 899 patients underwent treatment for achalasia of the esophagus at the Mayo Clinic, 431 by forceful hydrostatic or pneumatic dilation and 468 by a standardized transthoracic esophagomyotomy. Esophageal leak and mediastinal sepsis was an uncommon but major complication of both types of therapy, occurring four times more often with dilation (4%) than with myotomy (1%), although no deaths resulted from this in either group. The 30-day mortality was 0.2% after myotomy and 0.5% after forceful dilation. Although there was minimal morbidity and mortality with either modality, the late results were significantly superior after myotomy. Excellent to good results were obtained by 85% of the group treated with myotomy but only by 65% of those treated with hydrostatic dilation. Late poor results were encountered three times more frequently after dilation (19%) than after myotomy (6%). Analysis of poor results after myotomy indicates that late serious complications of gastroesophageal reflux developed in only 3% of patients operated on.
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PMID:Esophagomyotomy versus forceful dilation for achalasia of the esophagus: results in 899 patients. 8 37

Esophageal achalasia has not been reported in the literature as a complication of Hodgkin disease. Involvement of the esophagus is rare but when present, consists mostly of bleeding, ulceration or diverticuli. A case is reported in a fifty-one year old female with achalasia of the distal third of the esophagus associated with Hodgkin disease, Stage II B.
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PMID:Achalasia of the esophagus associated with Hodgkin disease. 11 Sep 85

Dysphagia is the leading symptom in the most frequent and surgically most important disturbances of the passage of the oesophagus. Possibilities and results of the treatment are analysed on the basis of clinical material from the surgical clinic of Halle university. Nevertheless insufficient results in malignant tumours are opposite to favourable results of the operation in benign diseases (diverticles, achalasia, strictures). Measures for the improvement of the situation of treatment are discussed.
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PMID:[The value of the symptom of dysphagia from the surgeon's viewpoint]. 11 48

Esophagogastroduodenoscopy (211,410 examinations) had a complication rate of 1.3/1,000 cases. Duodenoscopy with cannulation was performed 3,884 times and had a complication rate of 21.6/1,000 examinations. Diagnostic coloscopy (25,298 examinations) had a complication rate of 3.4/1,000. Polypectomies during coloscopy (6,124 cases) had a complication rate of 23.3/1,000 cases. Esophageal dilations (13,139 cases) had a complication rate of 4.25 with mercury bougies, and in 9,431 cases metal olives produced a complication rate of 6.1/1,000 treatments. Dilation for achalasia in 1,224 patients produced a complication rate of 18.4/1,000 procedures. Peritoneoscopy (4,404 examinations) produced a complication rate of 5.4/1,000 patients. The value of these diagnostic and therapeutic procedures is now well established but must be weighed against a potential risk of complications.
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PMID:Endoscopic complications. Results of the 1974 American Society for Gastrointestinal Endoscopy Survey. 12 42

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


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