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)

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

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

Oesophagocardial plasty combined with intrathoracic fundoplication (Thal-Nissen-Rosetti) appears to be efficacious in the treatment of severe achalasia and of stenosis resulting from reflux in hiatus hernia. Advanced age and moderately severe cardiorespiratory disorders do not preclude good results from this operation. The above procedure was applied to six patients, with results varying from very good to fair.
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PMID:The treatment of benign strictures in the distal portion of the oesophagus. 60 48

The use of endoscopic procedures in the evaluation of primary motor disorders, or functional diseases, of the esophagus is filled with both risks and benefits. Since both flexible and open-tube esophagoscopy carry a significant risk factor, it is necessary to have a clear concept of the indications and value of endoscopy in the management of functional diseases of the esophagus. A review of the literature reveals very little documentation on the value of endoscopy in diagnosing esophageal functional diseases other than Zenker's diverticulum and achalasia. Based on the current literature and the experience of the authors, observations and recommendations concerning the role of endoscopy in functional diseases of the esophagus are presented. These are: 1) In Phase I or upper esophageal sphincter dysfunctions, endoscopy contributes little to their understanding, is difficult to perform, and may be hazardous. In this group, esophagoscopy should be reserved for indications beyond the dysfunction itself. If endoscopy has to be performed, open-tube esophagoscopy should be performed by an experienced endoscopist. 2) In functional diseases of the esophageal body or Phase II dysfunction, endoscopy is frequently valuable. In spastic disorders, it helps to differentiate between primary spasm of neuromuscular origin and spasm secondary to esophagitis or an obstructive process. In scleroderma and pulsion diverticulum, endoscopy helps to identify such unsuspected complications as esophagitis, hiatal hernia, and carcinoma. 3) In Phase III or however esophageal sphincter dysfunctions, endoscopic examination is essential both to rule out organic lesions that stimulate functional disorders, and to determine the presence and extent of esophagitis.
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PMID:Functional diseases of the esophagus: role of endoscopy. 68 97

A prospective study of 595 patients treated by the Thoracic Surgical Unit (TSU) at the University College Hospital (UCH), Ibadan between July 1975 and December 1977 was carried out to determine the pattern of thoracic surgical diseases in Nigeria and to prove or disprove the rarity of certain cardiopulmonary diseases in tropical Africa. This review shows that pyogenic infections of the lung and pleura constitute the largest percentage (38.5) of the thoracic surgical diseases in Nigeria. Although pulmonary tuberculosis accounts for only 23.4 percent of our total inpatient load, it constitutes about 60 percent of our outpatient clinic practice. Cardiovascular diseases form 12.9 percent, notably congenital and acquired valvular heart diseases. An interesting finding was the occasional association of pyomyositis with pyogenic pericarditis and empyema thoracis. This triad is being investigated. Chest trauma was the most common thoracic surgical emergency accounting for 9.2 percent of the total thoracic surgical pathology. The most common causes of dysphagia are strictures from corrosive esophagitis, achalasia, and carcinoma of the esophagus. Present experience confirms the rarity of hiatus hernia, reflux esophagitis, atherosclerotic cardiovascular disease, and, perhaps, carcinoma of the lung among Nigerians.
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PMID:Pattern of thoracic surgical diseases in Nigeria: experience at the University College Hospital, Ibadan. 70 99

Only 18 or 83 patients who had had a cardiomyotomy for achalasia could be induced to reflux barium. Mucosal herniation through the myotomy was shown in most by radiography. Perfusion manometry showed a higher pressure zone in the oesophagogastric junction region in 22 of 24 patients studied. This high pressure zone responded to an increment in abdominal pressure by a greater increment. The same response was seen in a patient with a small hiatal hernia and myotomy. We concluded that the persisting high pressure zone seen by perfusion manometry is likely to be caused by the hiatus, and that the hiatus rather than the sphincter is likely to be responsible for the incremental response of the high pressure zone to increased abdominal pressure. The anti-reflux mechanism after cardiomyotomy is more likely to be the hiatal mechanism than persisting sphincter fibres.
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PMID:The anti-reflux mechanism after cardiomyotomy. 72 25

The indication for the non-resecting combination method arises if the presence of genuine ulcer disease is confirmed by complete diagnostic measures (history, roentgenologic examination, endoscopy, secretion analysis and possibly psychic testing). An extended indication exists for erosive gastritis with hypersecretion, for hiatal hernia with reflux esophagitis (Berman's syndrome), for cardiospasm and prophylaxis of hemorrhage. The technique yields permanent curative results if a complete selective proximal vagotomy is combined with a pyloroplasty suitable in form and function. This is also true for duodenal ulcer. In 22% of cases of gastric ulcer, selective vagotomy with antrectomy is necessary.
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PMID:[Non-resecting surgery for gastroduodenal ulcer. II. Indication and technique (author's transl)]. 81 5

During the last 12 years, 1489 vagotomies were performed at the Chirurgische Poliklinik of Munich University; 1339 of them were selective proximal vagotomies (SPV). The main indication was duodenal ulcer (n = 915) and gastric ulcer (n = 188), including emergency operations for extensive bleeding. Further indications were: sliding hiatal hernia, erosive gastritis and achalasia of the cardia. The SPA was combined in all cases with a pyloroplasty based on form and function. The results are shown in detail related to mortality (elective 0.5%), recurrency (1.6%) and functional results (good 88.2%, fair 7.2%, poor 4.6%). The combined operation of SPV with pyloroplasty is, in our opinion, an operative procedure which allows non resectioning surgical treatment of GDU without selection, i.e. based on form and function.
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PMID:[Non-resecting surgery for gastroduodenal ulcer. III. Clinical results (author's transl)]. 81 6

A new electronic transducer system has been developed for intraluminal pressure studies in the gastrointestinal tract. In contrast to other devices, inductance was used for the transformation of pressure into electrical signals. High sensitivity with a frequency response of 10(4) Hz guarantees accurate recording of sphincter as well as of peristaltic pressures. Pull-throughs can be carried out manually. Studies may be performed in the sitting as well as in the supine position since no hydraulic effects are present. No measurable temperature sensitivity was found; linearity is present in the physiological pressure range required. Small size, mechanical and electrical stability and simple handling make the PI-transducer system a suitable diagnostic tool for clinical as well as for investigatory purposes. By this method functional disorders of the esophagus, as in scleroderma, achalasia or hiatus hernia, of the pylorus and of the anal sphincter may be evaluated. The results of lower esophageal sphincter measurements in 30 asymptomatic volunteers and in 19 patients with symptomatic gastroesophageal reflux agree with the data obtained by conventional methods.
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PMID:A new electronic transducer system for gastrointestinal pressure studies. 86 16

Twenty-four patients with the 1st branchial arch (Goldenhar) syndrome have been ascertained ranging in age from newborn to 58 years. In infancy, the ocular, auricular, and palatal problems appear most prominent. In childhood, the correction of, or compensation for, hearing deficit assumes greater importance. Incoordination of deglutition, achalasia of the esophagus, hiatus hernia, and mobile cecum (hitherto unreported features) are characteristically troublesome in infancy and early childhood. Cosmetic problems though significant throughout, engender particular concern during adolescence and early adulthood. Spinal problems with early vertebral degenerative changes cause clinical difficulty requiring surgery during adulthood. Fertility appeared to be unimpaired and longevity is probably unaffected (although our oldest patient is less than 60 years old). Only three cases were mentally subnormal and none died following ascertainment.
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PMID:The Goldenhar syndrome: a natural history. 89 Jan 16


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