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)

A 19-year-old man first presented with clinical, radiological, and manometric features of diffuse spasm. Within a year his motility disorder progressed to "vigorous" and, finally, classic achalasia. After pneumatic dilatation and subsequent long myotomy, the features of classic achalasia disappeared and he again exhibited radiological and manometric evidence of "vigorous" achalasia. The evolution of this patient's disease provides evidence that diffuse spasm and achalasia are different stages of the same disease and lie at opposite ends of a spectrum of related esophageal motility disorders.
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PMID:Transition from diffuse esophageal spasm to achalasia. 26 36

A 12-year-old girl with achalasia was treated successfully under general anesthesia with pneumatic dilation after she had experienced two unsuccessful surgical procedures. The Mosher dilator was passed into the stomach by threading it over a guide wire. Our experience suggests that pneumatic dilation can be performed in children or adults after surgical failure and that general anesthesia may be employed.
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PMID:Pneumatic dilation under general anesthesia after unsuccessful cardiomyotomy for achalasia. 26 48

Postvagotomy dysphagia (PVD) has been attributed to either periesophageal obstruction or failure of the lower esophageal sphincter (LES) to relax, presumably from interruption of preganglionic, contraction-inhibiting vagal fibers--a postvagotomy achalasia (PVA). This report describes a patient with periesophageal fibrosis which was successfully treated with dilation, and a second patient with an achalasia-like pattern on esophageal manometry after unilateral high, transthoracic vagotomy. The second patient is the first manometrically documented example of achalasia in a human subject related to proximal vagotomy. Most, if not all, PVD is due to esophageal obstruction and PVA is rare.
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PMID:Mechanical and neurogenic factors in postvagotomoy dysphagia. 26 49

Thirty-three patients treated at the Karolinska Hospital for achalasia of the esophagus during the period 1968--78 have been reexamined. Twenty-eight of these patients underwent pneumatic dilatation. Excellent and good results were obtained in 79% of cases; in 21% the result was considered poor. In 2 cases the esophagus was perforated during dilatation--a perforation rate of 5% of the total number of dilatations. In 6 cases the lower sphincteric pressure was calculated before and after dilatation. It was found to be higher than normal, preoperatively, but reduced to a near-normal value postoperatively.
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PMID:Results of the treatment of achalasia by pneumatic dilatation. 28 58

An unusual, characteristic case of etiopathic achalasia of the esophagus is reported and the literature is reviewed. This disease has not previously been reported in the dental literature, but is well-known in the medical field. The case report illustrates the salient features of previosuly described achalasia in adults: vague history of asthma with respiratory symptoms of wheezing, obstruction to swallowing, regurgitation, intermittent pain, and peripheral neuritis in a thin patient who claims to be a light eater. The primary concern of the oral surgeon is the management of nutrition. In the case reported, to ingest food. After mobilization of the jaws, the patient could not longer eat the small amounts she could preoperatively. Suspected achalasiactic symptoms should be investigated thoroughly through proper work-up to rule out this disorder before elective surgery is performed. In nonelective cases, the practitioner must be prepared to manage the problems and complications and obtain the proper consultations.
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PMID:Esophageal achalasia after maxillofacial surgery. 28 92

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

Most investigators agree that the most important goal in correcting gastroesophageal reflux is restoring or developing a competent lower esophageal sphincter. Although the sphincter can be incompetent in its normal intra-abdominal position and rarely a patient may have a competent sphincter in the thorax, generally the sphincter is much more effective in the positive pressure abdominal position. The choice of operative technique will depend upon the abnormal conditions present and the general condition of the patient. The thoracic approach is elected if there is associated intrathoracic disease warranting surgical correction, such as diffuse spasm of the esophagus, achalasia, epiphrenic diverticulum, or a pulmonary lesion requiring biopsy and possible resection. Very obese patients, patients with recurrent hernias, and patients with shortened esophagus are better managed by the thoracic approach. Patients with an essentially normal esophagus are treated with a Mark IV Belsey procedure. If shortening of the esophagus is present, a combination Collis-Nissen technique with fixation below the diaphragm is preferable. The abdominal approach is indicated when there is another intraabdominal disease known or suspected warranting surgical correction. This approach is also useful for the thin or poor risk patient. Usually, through an abdominal incision, we elect to use a modified Nissen fundoplication, with fixation of the fundoplication to the median arcuate ligament or the right crus of the diaphragm. The crural sling is returned to normal dimensions with interrupted sutures. Reflux in the absence of an hiatal hernia initially is treated medically. If symptoms are significant and intractable, a competent lower esophageal sphincter is restored, or developed by the modified Nissen procedure just described. Most reflux strictures at the esophagogastric junction are reversible by dilatation and restoration of a competent sphincter. Firm, fixed, fibrous strictures occasionally cannot be safely dilated. These may be managed by a Thal procedure to correct the stricture and a Nissen fundoplication to prevent recurrent reflux.
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PMID:Surgical treatment of gastroesophageal reflux. 39 Jul 43

Fifty-eight patients with angina-like chest pain had esophageal manometric testing. Forty-three had no evidence of coronary artery disease at the time of referral or at subsequent contact; 15 patients were proven to have coronary artery disease. High-amplitude contraction waves were the most frequently found manometric abnormality (15 patients). Less frequent were increased duration of contractions, achalasia, and diffuse esophageal spasm; the latter was present in only 3 patients. An approach to the interpretation of information obtained during manometry is presented. Using this approach, the esophagus was strongly implicated as the cause of the pain in 20 patients and was suspect in 18 others. Seven patients had results that exonerated the esophagus, and in the 13 remaining individuals, the esophagus was probably not the offending organ.
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PMID:Esophageal manometrics in patients with angina-like chest pain. 40 71

Functional disorders of the esophagus may be divided into alterations of the pharyngeal and upper esophageal sphincter motor function, malfunction of the tubular esophagus and disorders of the lower esophageal sphincter. Radiology, endoscopy and manometry are essential in the evaluation of the individual patient, in lower esophageal sphincter insufficiency with reflux disease acid clearance, reflux provocation test, acid perfusion and pH metry should be added. Conservative vs. operative therapy has to be critically evaluated. The diagnostic criteria of the most common functional disturbances like idiopathic diffuse esophageal spasm, achalasia and scleroderma are presented and therapeutic efforts discussed.
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PMID:[Functional disorders of the esophagus. Diagnosis and therapy]. 42 3

Although infrequent, esophageal rupture is a serious complication of pneumatic dilatation for the treatment of achalasia. Because of an experience with delayed recognition of esophageal perforation in a patient with achalasia, we now examine the esophagus using a water-soluble contrast medium immediately following every pneumatic dilatation. This technique allows immediate detection of esophageal perforation.
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PMID:Desirability of roentgen esophageal examination immediately after pneumatic dilatation for achalasia. 42 20


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