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

The results from the 195 performed fibroesophagoscopies and 114 purposeful biopsies in different esophgus diseases are reported. In 65 of the examined -- cancer of the esophagus or cardia ventriculi was establised. The rest 122 patients are with non-malignant disease -- ulcers, polyps, diverticulums, varices, strictures, esophagitis, cardiospasm, etc. Cancer of esophagus and cardia ventriculi is proved in 93.93 per cent on the base of endoscopic data while another diagnosis was given in 29.30 per cent at the X-ray examinations of the same patients and at the clinical examinations of the patients in 40.1 per cent -- diagnostic errors were made. The purposeful biopsy gives 70.58 per cent of positive results and enables the differentiation of the tumor histological characterisitics.
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PMID:[Diagnostic possibilities of fibroesophagoscopy and target biopsy of the esophagus]. 122 12

For precise differentiation between organic and functional disorders of the oesophagus, the gastroenterologist makes use of radiology, endoscopy, and manometry, although a questionnaire may establish the final diagnosis in dysphagia with 95% accuracy. Combined therapy is gaining in increasing importance, such as dilatation of achalasia, bouginage of peptic strictures, implantation of prostheses and sclerosing of varices during endoscopy. For early diagnosis of carcinoma, close interdisciplinary cooperation between the ENT-specialist and the gastroenterologist is mandatory in panendoscopy of the squamous epithelium-lined aero-digestive system.
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PMID:[Oesophageal disorders: a gastroenterologist's view]. 712 Nov 43

The esophagus is involved by a wide range of pathologic processes that can be detected, defined, and staged with computed tomography (CT). These processes include esophageal carcinoma; benign esophageal tumors; inflammatory and infectious diseases; miscellaneous conditions such as Barrett esophagus, achalasia, and varices; and trauma and perforation. CT is usually performed to clarify findings seen with other imaging modalities or to stage a pathologic condition; however, it may be the primary imaging modality in some cases. Because of the critical location of the esophagus, it can be involved secondarily by other disease processes or as part of a systemic process. By being aware of the appearances of the various entities that affect the esophagus, the radiologist can play an important role in detecting and staging esophageal disease. Although the role of CT in the evaluation of esophageal disease has been controversial, recent developments such as spiral CT have the potential to renew interest in this application.
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PMID:CT of the esophagus: spectrum of disease with emphasis on esophageal carcinoma. 750 54

Diseases of the gastrointestinal tract may result in radiographic changes in the thorax. An abnormal chest radiographic finding is often the initial clue to the diagnosis of gastrointestinal disease. This article presents the commonly recognized and some unusual thoracic manifestations of significant primary esophageal diseases including achalasia, diverticula, carcinoma, duplication cysts, varices, esophageal perforation, and postoperative changes. Intraabdominal gastrointestinal processes such as pancreatitis or pseudocysts, gastric and colonic abnormalities, pneumoperitoneum, liver abnormalities, intraabdominal abscesses, and diaphragmatic hernias, which are frequently associated with intrathoracic abnormalities, are also reviewed. Awareness of changes on the chest radiograph produced by gastrointestinal disease allows prompt diagnosis and facilitates the appropriate confirmatory diagnostic study, such as esophagography or computed tomography.
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PMID:Manifestations of gastrointestinal disease on chest radiographs. 821 May 87

The safety, effectiveness and capabilities of therapeutic upper fibreoptic endoscopy in children undergoing therapeutic endoscopic procedures (n = 443) was studied. Therapy for gastrointestinal bleeding formed the major group (injection sclerotherapy for varices, n = 197 procedures; thermocoagulation for haemorrhagic gastritis, n = 1; and photocoagulation for Dieulafoy's disease, n = 1). Sclerotherapy was 97% effective in controlling acute bleeding and 84% effective in obliterating varices with no serious complications or deaths. Oesophageal dilatations for surgical, caustic, congenital and peptic strictures and achalasia (n = 193) were performed with no oesophageal perforations or deaths. Foreign bodies were retrieved (n = 34) with no failures or complications. Percutaneous endoscopic gastrostomy was performed (n = 11) with one failure, proceeding to an unsuccessful surgical gastrostomy. Miscellaneous procedures included endoscopic transpyloric tube placement (n = 5) and endoscopic diathermy of pyloric web (n = 1). Therapeutic fibreoptic endoscopy is therefore concluded to be safe and effective in children, replacing rigid oesophagoscopy and some traditional surgical approaches.
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PMID:Therapeutic upper gastrointestinal endoscopy in children: an audit of 443 procedures and literature review. 843 62

Fibreoptic endoscopy was performed on 5,086 consecutive patients with upper gastrointestinal tract disease (UGITD) symptoms, at two endoscopy centres in Khartoum over five years. Oesophageal disease was diagnosed in 559 patients (11%) comprising (20.5%) of all the positive findings. In 46% of all the endoscopies no abnormality was detected. The commonest oesophageal disease was varices occurring in 186 patients (3.7%) of the 5,086 endoscopies with a mean age of 33.5 +/- 12 and a male/female ratio of 3.4:1. Hiatus hernia occurred in 124 patients (2.4%) with a male/female ratio of 1.6:1, oesophagitis in 115 patients (2.3%) with a male/female ratio of 2:1. Carcinoma of the oesophagus was diagnosed in 108 patients (2.1%), with a mean age of 56 +/- 14 years and a male/female ratio of 1.4:1. Achalasia of the oesophagus occurred in 20 patients (0.4%), Mallory Weiss syndrome in 4 patients (0.08%) and benign strictures in 2 patients (0.04%).
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PMID:Oesophageal diseases in Sudan, diagnosed by fibreoptic endoscopy. 847 Mar 1

Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur.
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PMID:The spectrum of benign esophageal lesions: imaging findings. 1227 Nov 66

The barium esophagram is a valuable diagnostic test for evaluating structural and functional abnormalities of the esophagus. The study is usually performed as a multiphasic examination that includes upright double-contrast views with a high-density barium suspension, prone single-contrast views with a low-density barium suspension, and, not infrequently, mucosal-relief views with either density of barium suspension. The double-contrast phase optimizes the ability to detect inflammatory or neoplastic diseases, whereas the single-contrast phase optimizes the ability to detect hiatal hernias and lower esophageal rings or strictures. Fluoroscopic examination of the esophagus is also important for assessing motility disorders such as achalasia and diffuse esophageal spasm. This article is a review of gastroesophageal reflux disease, other types of esophagitis, benign and malignant esophageal tumors, varices, lower esophageal rings, diverticula, and esophageal motility disorders, all of which can be diagnosed with the aid of esophagography.
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PMID:Diseases of the esophagus: diagnosis with esophagography. 1617 17

The coexistence of achalasia and gastroesophageal varices has been reported sporadically in the English medical literature. We report the case of a 60-year-old Hispanic woman with cryptogenic cirrhosis who was referred for a liver transplant evaluation and subsequently developed progressive dysphagia to both solids and liquids as well as substernal chest pain and weight loss. Endoscopy revealed the presence of grade I esophageal varices and large fundic varices, as well as retained liquid and solid food in the distal esophagus. Radiographic and manometric studies were consistent with achalasia. After botulinum toxin (Botox) injections were no longer effective a transjugular intrahepatic portosystemic shunt was performed for portal decompression before proceeding with pneumatic dilation. Optimal treatment of these 2 conditions, when they occur simultaneously, is problematic. We discuss this patient's management and our approach to this infrequent combination of diseases.
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PMID:Achalasia in a patient with gastroesophageal varices: problematic treatment decisions. 1641 6

Multi-detector computed tomography (CT) offers new opportunities in the imaging of the gastrointestinal tract. Its ability to cover a large volume in a very short scan time, and in a single breath hold with thin collimation and isotropic voxels, allows the imaging of the entire esophagus with high-quality multiplanar reformation and 3D reconstruction. Proper distention of the esophagus and stomach (by oral administration of effervescent granules and water) and optimally timed administration of intravenous contrast material are required to detect and characterize disease. In contrast to endoscopy and double-contrast studies of the upper GI tract, CT provides information about both the esophageal wall and the extramural extent of disease. Preoperative staging of esophageal carcinoma appears to be the main indication for MDCT. In addition, MDCT allows detection of other esophageal malignancies, such as lymphoma and benign esophageal tumors, such as leiomyma. A diagnosis of rupture or fistula of the esophagus can be firmly established using MDCT. Furthermore, miscellaneous esophageal conditions, such as achalasia, esophagitis, diverticula, and varices, are incidental findings and can also be visualized with hydro-multi-detector CT. Multi-detector CT is a valuable tool for the evaluation of esophageal wall disease and serves as an adjunct to endoscopy.
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PMID:Dedicated multi-detector CT of the esophagus: spectrum of diseases. 1765 87


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