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)

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

Symptoms of dysphagia and chronic vomiting often are categorized as being elicited by psychogenic factors, when no explanation can be found by fluoroscopic and endoscopic means. Psychogenic factors were also thought to be of aetiological significance in 58 patients referred under the diagnoses "psychogenic", "psychosomatic", and "functional" swallowing disorder, "psychogenic vomiting", "conversion neurosis", "anorexia nervosa", "psychosomatic disturbances in pregnancy", "cancer phobia", "cardiac phobia (DaCosta syndrome)", and "depressive disorder" to the Psychophysiology Unit, University of Vienna, for further evaluation. However, manometric, pH-metric, and endoscopic investigations showed that all of these patients suffered in fact from organic disorders: 36 from achalasia, 5 from vigorous achalasia, 5 from diffuse oesophageal spasms, 6 from lower oesophageal contraction abnormalities, one from pharyngo-oesophageal dyscoordination, one from a gastric ulcer ad cardiam, and 4 from gastro-oesophageal refluxes of whom one also had a hypertonic upper oesophageal sphincter. These findings, together with the fact that all concepts relating swallowing disorders to psychogenic factors have remained purely speculative, show that it is not justifiable to label dysphagic symptoms, for which no organic aetiology can be detected, as "psychogenic" or "psychosomatic". Patients with such symptoms should be studied by means of oesophageal manometry and/or pH-metry to reveal the nature of their disorder and to enable adequate therapy.
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PMID:[Differential diagnosis of psychosomatic deglutition disorders]. 378 84

Endoscopic ultrasonography is recognized as an important tool in the diagnosis and staging of esophageal, gastric, colorectal, pancreatic, and biliary tumors. It also is a reliable method for the evaluation of submucosal tumors of the gastrointestinal tract, the differentiation between benign and malignant giant gastric folds, the evaluation of gastric ulcer healing, and the detection of common bile duct stones. The recent introduction of endoscopic ultrasonographic fine-needle aspiration provides for the cytologic and histologic diagnosis of gastrointestinal submucosal and extraluminal tumors and regional lymph nodes. This new technique may also be used for the intrasphincteric injection of botulinum toxin in the treatment of achalasia, for the steroid injection treatment of refractory esophageal strictures, for celiac nerve block, for pseudocyst drainage, and for drug delivery into pancreatic tumors. High-frequency thin ultrasonic probes can be used to make a more accurate diagnosis of superficial carcinomas of the gastrointestinal tract and for intraductal ultrasonography of the extrahepatic bile duct and pancreatic duct. In the future, three-dimensional imaging of gastrointestinal tumors will provide more accurate information regarding cancer extent. Endoscopic ultrasonography is a powerful tool which can be used in the diagnosis and treatment of a variety of gastrointestinal diseases.
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PMID:Recent advances in endoscopic ultrasonography. 1077 53

Pseudoachalasia is a rare secondary achalasia, which accounts for only a small subgroup of patients. We describe a 77-year-old woman with recent onset of dysphagia and typical esophageal manometric findings of achalasia. Moreover, esophageal manometric findings of vascular compression at 36 cm from the nose were associated with dysphagia. An upper endoscopy showed the absence of lesions both in the esophagus and gastro-esophageal junction, whilst a 15-mm ulcer on the gastric angulus was detected. The gastric ulcer resulted in being a diffuse signet ring cell carcinoma at histology, suggesting pseudoachalasia. An abdominal computed tomography scan showed an irregular concentric thickening of the gastro-esophageal junction wall extending for 7 cm and a dilated ascending thoracic aorta with no presence of the inferior vena cava, with an enlarged azygos as the source of vascular compression of esophagus. Moreover, cardia involvement from diffuse signet ring cell carcinoma of the gastric angulus was also recognized as the cause of dysphagia. The cancer was not suitable for a surgical approach in an old patient with cardiovascular comorbidities and support therapy was started. In our ambulatory series, pseudoachalasia was eventually diagnosed in 4.7% of 234 consecutive patients with esophageal manometric finding suggestive of achalasia. We also reviewed cases in the literature and aimed to evaluate the reported causes of pseudoachalasia.
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PMID:Pseudoachalasia: A peculiar case report and review of the literature. 2404 45