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

Four cases of megaesophagus with esophageal motor disturbances secondary to adenocarcinoma of the cardia are hereby reported. There were common characteristics to all cases such as: 1) short duration of symptoms, 2) grade II megaesophagus by X-Rays with narrowing of the cardia, 3) the endoscopy showed esophageal dilatation and inability to pass the cardia with the endoscope, 4) histology (obtained by endoscopy or surgery) and exfoliative cytology were positive for malignancy, 5) the esophageal motility tests showed aperistalsis of the whole esophagus in all cases, and lack of relaxation of the lower esophageal sphincter in two. The urecholine test was positive in one patient with neoplastic infiltration of the myenteric plexus, 6) in two cases where esophageal resection was performed, infiltration of the Auerbach's plexus by cancer cells was proven. We conclude that in the presence of aperistalsis of the esophagus with or without achalasia of the lower esophageal sphincter, the diagnosis of megaesophagus secondary to cancer of the gastric fundus should be suspected when it is not possible to pass the cardia with the endoscope, even if biopsy and cytology are negative for malignancy.
 ...
PMID:[Megaesophagus secondary to carcinoma of the cardia: apropos of 4 cases]. 653 56

In six patients with achalasia of the esophagus who previously underwent, one or more times, cardiomyotomy and had a failure of the procedure, we have done a new operation, an abdominal laterolateral anastomosis between the esophagus and the gastric fundus (Heyrowsky), wrapping it up with the stomach to form a genuine fundoplication. The six patients were preoperatively and postoperatively evaluated roentgenographically, endoscopically and manometrically, and the results were good with no reflux, and the drainage effect of the operation was excellent. This technique is a recourse for patients who have a recurrence of dysphagia after the Heller operation, because it has been ineffective, since it sometimes occurs in a rather large megaesophagus.
 ...
PMID:The Heyrowsky operation associated with fundoplication for the treatment of patients with achalasia of the esophagus after failure of the cardiomyotomy. 663 17

The physiologic similarities between the megaesophagus of Chagas' disease and idiopathic achalasia are well documented. Therefore, it would seem reasonable that comparisons of controlled trials of therapy for the more common Chagas' megaesophagus could be applied to idiopathic achalasia, where the paucity of cases makes such a controlled comparison difficult. We had the opportunity to study 18 patients with achalasia secondary to Chagas' disease. All of the patients were from the mid central states of Brazil, all had symptoms of dysphagia and radiographic documentation of dilated esophagus and abnormal peristalsis (Rezende Groups II and III), as well as positive serologic evidence of Chagas' disease. Perfused intraluminal manometric studies were performed on all patients. Resting sphincter pressures ranged from 20-35 mm./Hg., mean of 25 (normal 5-12 mm./Hg.) with aperistalsis. Patients were randomly dilated with either bouginage (44-55 ff catheter) or pneumatic dilator (4-4.5 kg./6.5 cm.2 x 2 min.). Although all patients reported symptomatic improvement several days after either procedure, repeat manometric tracings demonstrated no change in the sphincter pressure in the bouginage group. The pneumatically dilated group, however, demonstrated a decrease in sphincter pressure to normal levels (mean 12 mm./Hg.). Follow-up studies one year after the procedure confirmed the persistence of normal sphincter pressure in the pneumatically dilated group but no change, as well as return of initial symptoms, in the bouginage group.
 ...
PMID:A clinical trial with pre- and post-treatment manometry comparing pneumatic dilation with bouginage for treatment of Chagas' megaesophagus. 678 91

The authors reported seven cases of megaesophagus by achalasia in children treated by transabdominal esophagomyotomy. There were five girls and two boys. Nor infantile neither familial forms were seen. Five children were cured clinically and radiologically at the third post operative month. Two failures were successfully treated by Thal's procedure. We concluded: (1) Infantile achalasia is not rare in recent literature; recurrent respiratory troubles and familial forms are frequent; prognosis is serious in this age groups. (2) Esophagus's width divided by thoracic vertebral corpus's height is a more objective criteria to appreciate megaesophagus's importance than esophagus's width alone. (3) Endoscopic biopsy is inadequate to detect tracheo bronchial remnants. (4) Appropriate treatment in children is surgical esophagomyotomy with fundoplication.
 ...
PMID:[Megaesophagus by achalasia in children (seven cases) (author's transl)]. 707 22

Radiological features of the oesophagus of 7 normal horses and 13 with oesophageal lesions are described. The use of barium sulphate as a contrast agent and the techniqes of its administration are discussed. It is suggested that chronic intermittent oesophageal impaction with food material was a predisposing factor in the development of a localised oesophageal dilation in 3 horses and that one other probably resulted from an injury. A similar dilatation was seen which resulted from oesophageal constriction by a vascular ring. Megaoesophagus was seen in 2 ponies associated with grass sickness and a third case had a more localised ares of dilatation in the distal thoracic oesophagus. Other abnormalities recognised included slow passage of food material through the cranial oesophagus which was seen in 3 horses; one as a sequel to a laryngoplasty operation, the second was the probable result of chronic aerophagia and the third was a congenital abnormality. Oesophagoscopy was found to be a useful adjunct to radiography in the diagnosis of oesophageal disorders in horses.
 ...
PMID:Observations on the potential role of oesophageal radiography in the horse. 708 83

While Heller's myotomy has become the accepted operation for achalasia, still, there is no agreement about the indications for and choice of complementary procedures to minimize subsequent acid esophageal reflux. In the instances described in this investigation Heller's operation was accompanied by proximal gastric, or highly selective, vagotomy and anterior fundoplication. Dysphagia was abolished and normal alimentation restored in all but one patient, who was elderly and had an advanced megaesophagus. In every patient after the operation, results of pH-manometry, acid reflux tests and endoscopy demonstrated the absence of both acid reflux and esophagitis.
 ...
PMID:Proximal gastric vagotomy and anterior fundoplication as complementary procedures to Heller's operation for achalasia. 711 62

Miniature Schnauzers maintained in a colony for 9 years were used to study the inheritance of esophageal dysfunction (canine achalasia, megaesophagus). All dogs were evaluated radiographically, using a barium swallow contrast technique which clearly distinguished normal and affected pups. At 4 to 6 months of age, all affected dogs had recovered clinically except one, and radiographic evidence of dysfunction was markedly diminished. None of the affected dogs required a special feeding regimen. Analysis of breeding pairs revealed a ratio of 9 affected/11 normal dogs when an affected male was mated with a normal female, and a 13/3 ratio was observed when two affected dogs were mated. These ratios were compatible with a simple autosomal dominant or a 60% penetrance autosomal-recessive mode of inheritance. Outbreeding to an affected Miniature Schnauzer/Poodle crossbred dog resulted in only two of 30 affected pups, indicating a polygenic mode of inheritance in outbred populations.
 ...
PMID:Hereditary esophageal dysfunction in the Miniature Schnauzer dog. 718 91

A pneumatic dilator for the treatment of achalasia of the esophagus is described. An inflatable polyurethane balloon assembly is attached to a small-caliber forward-viewing fiber-optic gastroscope. The balloon is introduced and dilatation carried out under endoscopic visual control. The described method greatly increases the safety and accuracy of the dilatation procedure, even in patients with an extreme degree of megaesophagus. 39 patients have been successfully treated with the dilator with no complications.
 ...
PMID:Treatment of achalasia with a pneumatic dilator attached to a gastroscope. 725 87

A man with a mediastinal mass shadow detected on chest roentgenogram was diagnosed as having achalasia by barium swallowing study. Megaesophagus caused by achalasia produced airway obstruction. Maximum expiratory-inspiratory flow volume curve identified that peak flow rate decreased in early expiration, and the ratio of expired to inspired flow at 50 percent of vital capacity was below 0.9, aggravated by 250 ml water intake. Deformation of the tracheal shape was proved easily.
 ...
PMID:Airway obstruction in achalasia. 739 31

A symptomatic megaesophagus was demonstrated in a three months old boy with Chagas disease. He had a difficult evolution with frequent aspiration pneumonias and progressive undernutrition. At 14 years old a cardiomyotomy (Heller's procedure) was performed, with good results that allowed a near normal life. At 27 years old, the patient started with progressive dysphagia due to an epidermoid esophageal carcinoma and died after surgery. Since a higher frequency of esophageal carcinoma is observed in achalasia, periodic endoscopic examinations are mandatory.
 ...
PMID:[A case of congenital chagasic megaesophagus: evolution until death caused by esophageal neoplasm, at 27 years of age]. 780 23


<< Previous 1 2 3 4 5 6 7 8 Next >>