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

The results of modified Thal (cardioplasty with gastric patch) in the surgical treatment of oesophageal achalasia are reported. Clinical, endoscopic, radiological, pHmetric and manometric findings offer evidence of the value of the technique.
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PMID:[Modified Thal operation in the treatment of achalasia of the esophagus]. 50 44

Delayed esophageal emptying of a radiolabeled meal distinguished symptomatic achalasia patients from asymptomatic controls. Esophageal emptying of the isotope meal significantly improved in ten achalasia patients after pneumatic dilation, and in one patient after surgical myotomy. The emptying curve in some patients after treatment simulated that of control subjects. Quantitation of esophageal emptying by a radiolabeled meal is a physiologic test that may be useful in evaluating results of therapy for achalasia.
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PMID:Esophageal emptying in achalasia quantitated by a radioisotope technique. 51 96

Four cases of H-type tracheoesophageal fistula are reported. The patients all had chronic aspiration from the esophagus. Although serious symptoms were present in all, definitive diagnoses were not made until the patients had reached 1, 6, 12, and 50 years of age, because ordinary radiologic methods failed to establish the diagnosis. The angulation of the fistula usually prevents contrast medium in the esophagus from entering the trachea, especially with the subject upright. On the other hand, air easily passes from the trachea to the esophagus, eventually producing megaesophagus which may be confused with the picture of achalasia. An ill-advised Heller esophagomyotomy was done on 1 patient. All 4 patients eventually had successful closure of the fistulas. Three operations were by the transthoracic route, and 1 high fistula in an infant was closed through a cervical approach.
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PMID:Diagnosis and surgical treatment of "H-type" tracheoesophageal fistulas. 51 80

Heller's cardiomyotomy or one of the modifications are not sufficient in the third stage of achalasia. Additional surgery is required for reversion of the dilated and elongated esophagus. Two patients with third-grade achalasia were treated by cardiomyotomy in combined with esophagomyoplication and followed up for one year. The results were evaluated clinically, radiologically, manometrically, pH-metrically, and endoscopically. We concluded that esophagomyoplication satisfactorily completes cardiomyotomy in cases of third-grade achalasia.
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PMID:[Esophageal myoplicature in the treatment of decompensated achalasia]. 52 99

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

Six cases of esophagogastric junction carcinoma are reviewed, with emphasis placed on differential diagnosis between achalasia and carcinoma. All six had abnormal motility with aperistalsis being the most common finding. Three patients demonstrated tapering of the distal esophagus simulating achalasia. Patients over 40 with recent onset of esophageal symptoms and radiographic signs suggesting achalasia should be suspected of harboring carcinoma.
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PMID:Secondary achalasia in esophagogastric carcinoma:re-emphasis of a difficult differential problem. 54 72

The authors undertook a retrospective study of a series of 17 cases of idiopathic megaoesophagus seen over a period of 25 years in two paediatric surgery departments. Age distribution was regularly between 20 months and 15 years. No neonatal nor familial forms were seen. Symptoms were dominated by regurgitation and dysphagia. Weight loss was an almost constant feature. Heller's operation, via an abdominal approach with retro-oesophageal valve of the tuberosity fixed to both edges of the myotomy, was the operation proposed. In one case of recurrent megaoesophagus operated upon elsewhere a Thal operation gave a good result with a follow up of 8 years. Immediate clinical and radiological results were favourable in the great majority of cases : 16 cases out of 17. Long term results (follow up of more than 5 years in 8 patients) were also favourable. However one patient was sometimes troubled by regurgitations due to persistent achalasia and a grave failure occured in a patient who five years after a Heller operation developed a peptic stenosis of the lower oesophagus. No recurrence of megaoesophagus was seen. The authors emphasise the importance of the prevention of gastro-oesophageal reflux and the value of oesophagoscopy and of manometry in cases where the result of a Heller's operation is imperfect.
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PMID:[Idiopathic megaoesophagus in the child. A series of 17 cases treated surgically (author's transl)]. 54 68

Twenty-year-old twin sisters, believed monozygotic on the basis of extensive blood grouping and cytogenetic studies, are reported. One twin demonstrated classical clinical, radiologic, and manometric features of achalasia, while similar studies in her sister documented perfectly normal esophageal motor function. Genetically determined damage to the esophageal parasympathetic innervation is, therefore, not a likely cause for the esophageal motor dysfunction in achalasia.
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PMID:Discordance for achalasia in identical twins. 57 88

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

Based on in vivo studies on isolated muscle strips of the LES and on manometric in vivo studies on 8 mongrel dogs, 6 healthy volunteers, 6 patients with achalasia and 3 subjects with diffuse esophageal spasm we could demonstrate that nifedipine causes a long-lasting relaxation of smooth muscle, the esophagus and LES. In 8 dogs resting pressure at the LES was decreased by 20 mg nifedipine from 18.5 +/- 1.8 mm Hg to 8.2 +/- 0.9 mm Hg. This pressure decrease could not be reversed by pentagastrin stimulation (3.0 microgram/kg KG PG). The resting pressure in LES was decreased from 26.8 +/- 3.8 mm Hg to 16.4 +/- 2.1 mm Hg in healthy volunteers and from 45.5 +/- 2.6 mm Hg to 14.5 +/- 0.4 mm Hg in patients with achalasia. In 3 patients with diffuse esophageal spasm nifedipine (20 mg) caused a mean decrease of 38% of the contraction amplitude. Further clinical studies have to be done to clarify if the spasmolysis by nifedipine may be important in the treatment of spastic or hypertonic motility disorders of the LES and the esophagus.
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PMID:[Clinical and experimental studies on the efficiency of nifedipine on smooth muscle strips of the esophagus (author's transl)]. 59 46


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