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)

Ten consecutive patients (ages 10 to 17) with achalasia of the esophagus diagnosed by radiographic, manometric, and endoscopic criteria were treated by forceful dilatations of the lower esophageal sphincter. A good to excellent response was seen in eight of the ten patients, manifested by disappearance of vomiting, improvement in dysphagia, and weight gain. A decrease in resting gastroesophageal sphincter pressure was documented in four patients tested. Short-term complications of fever or chest pain were seen following three of 18 procedures; however, barium swallow was negative for perforation and symptoms resolved spontaneously without treatment. Our findings suggest that pneumatic dilatation may produce similar results as surgical esophagomyotomy (Heller procedure) without the immediate operative morbidity, cost, and potential long-term effects.
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PMID:Successful treatment of achalasia in childhood by pneumatic dilatation. 725 67

A 7-month-old dystrophic infant weighing 3.8 kg was investigated endoscopically in relation to recurrent pneumonia. A tracheo-esophageal cleft was demonstrated. The situation was complicated by the coexistence of achalasia of the cardia. There was also hypertelorism and malformation of the urinary tract, so that this would appear to be a case of the G-Syndrome. A Heller's operation with fundoplication and gastrostomy was performed and only after this was the tracheooesophageal cleft closed. A flap of sternomastoid muscle was interposed between the trachea and oesophagus. Stenosis was treated by dilatation.
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PMID:[Laryngo-tracheo-oesophageal cleft and G-syndrome--interposition of a flap from the sternocleidomastoid muscle (author's transl)]. 728 28

We observed 17 cases of so-called recurrences of achalasia of the cardia (10 times after preceding dilatation and 7 times after Heller's operation). For surgical treatment 16 of these patients underwent cardiomyotomy, using the transthoracic approach. In one patient who had cardiomyotomy plus fundoplication at the first operation an oesophago-gastrostomy became necessary. Three quarter of these patients had a satisfactory result when followed up. I case of recurrence the authors recommend to give priority to cardiomyotomy, rather than to dilatation or bougienage.
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PMID:[Recurrences after surgical treatment of achalasia of the cardia (author's transl)]. 733 77

Retrograde gastric mucosal prolapse into the esophageal vestibule producing incomplete obstruction, following a Heller's procedure for achalasia of the esophagus, is reported.
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PMID:Retrograde mucosal prolapse following a Heller's correction for achalasia of the esophageal cardia. 735 43

The incidence of achalasia in children is lower than that in adults, but the disturbances in growth and development, and the severity of pulmonary symptoms are more profound. We have treated 20 children with the disease over the past 20 yr. All children were first treated with dilatation of the cardioesophageal junction either with filoform and followers, or in older children, pneumatic dilatation under fluoroscopic control. Five children, all older than 9 yr of age and all female, had prolonged relief of symptoms following two dilatations and never required a surgical procedure. Fifteen children responded unsatisfactorily to repeated dilatation and 12 of these accepted a surgical procedure. A modifier Heller procedure was performed in 11 children and one patient was treated with a transthoracic cardioplasty. The operations resulted in dramatic relief of symptoms, satisfactory weight gain, and the disappearance of pulmonary symptoms in every case. We recommend that all children under 9 yr of age should have a modified Heller procedure as primary therapy. In children older than 9 yr of age, dilatation is an appropriate initial therapy but should not be repeated unless significant improvement results.
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PMID:Achalasia in childhood: a 20-year experience. 741 56

In most centers the myotomy described by Heller and Zaayer is presently the treatment of choice for achalasia. Scrutinised reports show that the results of this operation are marred by complications. The reason is obvious: an insufficient myotomy may fail to relieve the symptoms of dysphagia and an incision sufficient to relieve obstruction may result in reflex oesophagitis. The technique described by Belsey consisting of a long myotomy combined with an antireflux procedure seems to be superior. The rational of this operation and preliminary results are discussed.
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PMID:Preliminary results of a long myotomy with antireflux procedure for achalasia of the oesophagus. 741 97

Achalasia is thought to be closely related to other motility disorders of the esophagus. In spite of this, transition between these disorders has rarely been documented. We present a patient who underwent a transition from a nonspecific motility disorder to achalasia. In addition there was return of peristalsis following a Heller myotomy.
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PMID:Transition form nonspecific motility disorder to achalasia. 741 27

A patient who, eight years prior, had a Heller operation for achalasia developed hypertrophic osteoarthropathy possibly secondary to a leiomyoma of the esophagus with sarcomatous changes. No local invasion or metastases were found. Total esophagectomy completely cured the esophageal symptoms and relieved the swelling and pain of her knees and other joints. This case illustrates the hypertrophic osteoarthropathy syndrome, its marked diagnostic significance and its occurrence secondary to an esophageal leiomyoma and leiomyosarcoma.
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PMID:Hypertrophic osteoarthropathy with myogenic tumors of the esophagus. 742 77

The results of Heller myotomy with Belsey fundoplication in the treatment of 32 patients with achalasia is reviewed. Eighteen who received no previous surgical treatment had good to excellent results. Fourteen patients who had undergone previous Heller myotomy without an antireflux procedure required further surgical treatment. Inadequate myotomy and reflux esophagitis were the causes of failure. In this group four patients who were treated by myotomy, Collis gastroplasty and the Belsey procedure still failed to achieve good to excellent results. The authors conclude that gastroplasty is contraindicated in patients with achalasia.
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PMID:Treatment of achalasia: esophagomyotomy with antireflux procedure. 744 64

A patient with a recurrent achalasia of the cardia was found, after a Heller cardiomyotomy, also to have pyloric insufficiency necessitating gastric resection. The pylorus appeared to contain virtually no ganglia at all. On the basis of an experiment with rabbits, in which vagotomy was shown to have no appreciable effect on the ganglion cells in the pylorus, it was concluded that the abnormality demonstrated in this patient could not be attributed to a possible injury of the vagus nerves but was probably due instead to achalasia of the pylorus.
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PMID:Achalasia of the cardiac sphincter and the pylorus? 746 94


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