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)

Secondary esophageal achalasia due to malignancy is a rare condition; only 53 such cases have been reported to date. Sixty-two percent of the cases were due to gastric adenocarcinoma. Mesothelioma of the peritoneum is an uncommon neoplasm. The usual presenting symptoms are abdominal pain, abdominal mass, or abdominal distention. The patient we are reporting had peritoneal mesothelioma which presented with dysphagia and weight loss, in addition to the radiological and manometric picture of achalasia. Secondary achalasia was suspected clinically, and was confirmed by computed tomography and laparotomy. The diagnosis of peritoneal mesothelioma was made only by histopathological examination. We are not aware of any other report documenting the association of peritoneal mesothelioma and achalasia.
Am J Gastroenterol 1990 Dec
PMID:Peritoneal mesothelioma: an unusual cause of esophageal achalasia. 225 28

Although squamous cell carcinoma of the esophagus occurs with increased incidence in primary achalasia, esophageal adenocarcinoma has been considered rare in this condition. We report a patient with long-standing achalasia in whom adenocarcinoma of the esophagus occurred many years after Heller esophagomyotomy, presumably related to Barrett's esophagus complicating gastro-esophageal reflux disease.
Dig Dis Sci 1990 Dec
PMID:Esophageal adenocarcinoma in a patient with surgically treated achalasia. 225 39

A patient with a "thoracic succussion splash" due to achalasia is described. She noted a splashing or sloshing sensation in her chest related to jogging and bending. On examination a splashing sound could be heard over the mid sternum and the posterior chest when the patient was rocked vigorously back and forth.
J Clin Gastroenterol 1990 Dec
PMID:Thoracic succussion splash: a new symptom and sign of achalasia. 226 44

Achalasia is a motor disease of the oesophagus which can be treated surgically (myotomy), medically or by dilatation. After myotomy satisfactory results are obtained in 84%-95% of the patients. Unacceptable results are due primarily to gastro-oesophageal reflux, inadequate or healed myotomy. Dilatation provide good results in about 70% but generally repeated dilatation is required. The remaining 30% can usually be treated surgically. Dilatation is complicated by perforation in about 3% of the patients, but reflux is not as frequent as after myotomy. At present medical treatment is only indicated temporarily prior to dilatation or surgery. Surgical treatment is recommended for patients with contemporary delayed gastric emptying, hiatal hernia, vigorous achalasia, epiphrenic diverticula and for children with achalasia. For the remaining patients both methods can be used but after 2-3 dilatations myotomy is recommended.
Ugeskr Laeger 1990 Dec 31
PMID:[Treatment of esophageal achalasia]. 227 52

Forty-eight patients with achalasia of the cardia were treated by Heller's myotomy with a posterior fundoplication of approximately 270 degrees, suturing the gastric fundus to the edges of the myotomy. The mean(s.d.) postoperative follow-up period was 5.4(2.8) years. The clinical results were good to excellent in 44 cases (92 per cent) and fair in four cases (8 per cent) (two with residual dysphagia and two with gastrooesophageal reflux). Barium studies showed a decrease in oesophageal diameter and disappearance of distal narrowing but normal oesophageal emptying did not occur. Postoperative manometric studies (29 patients) revealed a significant decrease in lower oesophageal sphincter pressure and a significant increase in the length of the infradiaphragmatic segment. In the oesophageal body a recovery of peristaltic waves in the proximal third was seen in ten of the patients (34 per cent). Twenty-four-hour pH monitoring showed pathological reflux in only three of 25 patients studied, and one of these was asymptomatic. This technique is effective, improving oesophageal symptoms and controlling long-term reflux.
Br J Surg 1990 Dec
PMID:Achalasia of the cardia: long-term results of oesophagomyotomy and posterior partial fundoplication. 227 22

A 4 9/12-year-old boy with achalasia microcephaly syndrome (AMS), born to a consanguineous couple, is reported. Comparative analysis of this case and the patients previously described in a Mexican family supports the notion that the syndrome is a distinct autosomal recessive condition. It is interesting that the area of origin and ethnicity of both the present and the previously reported cases is northwest Mexico.
Clin Genet 1989 Dec
PMID:Achalasia microcephaly syndrome in a patient with consanguineous parents: support for a.m. being a distinct autosomal recessive condition. 259 Oct 72

A very rare complication of achalasia (cardiospasm) is presented. In the authors' case the esophagus of a 15-year old girl was dilated to a great extent and caused through the compression of the trachea upper respiratory obstruction. Following the surgical solution of the achalasia the respiratory complications ceased too. Attention is drawn to the possibility that esophagus diseases may play a significant role in the etiology of different pulmonary diseases.
Orv Hetil 1989 Dec 17
PMID:[Severe tracheal compression caused by achalasia]. 260 58

In the US, the cumulative lifetime risk of developing carcinoma of the upper gastrointestinal tract is less than 1 per cent, premalignant conditions are uncommon, and esophageal and gastric malignancies are rarely curable even when identified early. Endoscopic screening of the upper gastrointestinal tract in asymptomatic persons thus cannot be justified. Surveillance of persons with certain uncommon conditions associated with a higher risk of upper gastrointestinal cancer may be of benefit. These conditions include achalasia, Barrett's esophagus, chronic atrophic gastritis with intestinal metaplasia, familial polyposis coli, gastric polyps, lye stricture, Plummer-Vinson syndrome, and tylosis. In the lower gastrointestinal tract, however, the lifetime risk of developing carcinoma is 5 per cent, premalignant conditions and lesions are common, and carcinoma is curable when detected at an early stage. Sigmoidoscopic screening of asymptomatic adults has been advocated by the American Cancer Society but has not become widely practiced because of its cost, required physician effort, low overall yield, and poor patient compliance. Surveillance by flexible sigmoidoscopy is recommended for persons at slightly increased risk of colorectal carcinoma who have prior breast or gynecologic malignancy or a family history of colorectal malignancy. Colonoscopic surveillance is recommended for patients with high risk of colorectal cancer who have had prior colorectal carcinoma or adenoma or who have inflammatory bowel disease or a ureterosigmoidostomy.
Surg Clin North Am 1989 Dec
PMID:Endoscopic screening and surveillance for gastrointestinal malignancy. 268 51

Smooth-muscle specimens from the lower esophagus of nine patients operated on for esophageal achalasia were examined with routine hematoxylin-eosin staining. This procedure revealed only a few eosinophils in or between the external smooth-muscle layers. Using specific immunohistochemical methods for the detection of the eosinophil cationic protein (ECP), however, varying degrees of eosinophil infiltration and extracellular deposit of ECP were disclosed in the achalasia specimens. The ECP also reacted with the monoclonal antibody, EG2, indicating secretion of the cytotoxic ECP. Few or no eosinophils were seen in the muscularis externa in specimens from six control patients without esophageal disease. In two controls many eosinophils were observed in the muscularis externa. However, no extracellular ECP was detected and very few eosinophils reacted with the monoclonal antibody (EG2), suggesting that these eosinophils were not activated. Depletion or total absence of peptidergic innervation was seen in all achalasia specimens but not in controls. Since the eosinophil cationic protein (ECP), in its activated form, is cytotoxic, we propose a pathogenic role of the eosinophil infiltration in achalasia.
Dig Dis Sci 1989 Dec
PMID:Eosinophil infiltration in primary esophageal achalasia. A possible pathogenic role. 268 11

The standardized 99mTc-labelled solid bolus oesophageal egg transit test (OET) was developed for assessing oesophageal motility. Its value in detecting oesophageal motility disorders was compared with oesophageal manometry in 102 symptomatic patients. Of 32 patients with normal OET, 22 (68.8 per cent) had normal manometry, whereas of 61 patients with abnormal manometry, 51 (84 per cent) had abnormal OET (chi 2 = 15.82, P less than 0.001). The computer-generated condensed image of the OET clearly defined five transit patterns: normal (n = 32); oscillatory (n = 21); non-clearance (n = 16); 'step' delay (n = 16) and non-specific delay (n = 17). The oscillatory pattern occurred in only one patient with normal manometry, but in all six with manometrically defined achalasia and two with diffuse oesophageal spasm. The predictive value of a positive (abnormal) OET test in detecting abnormal motility (both specific and non-specific disorders) was 73 per cent, and for specific motility disorders was 100 per cent. The predictive value of a negative (normal) test in excluding specific motor disorders was 94 per cent. Manometric tertiary contractions and low amplitude waves occurred in 6/32 and 1/32 patients with normal OET but in 31/70 and 21/70 with abnormal OET (chi 2 = 5.14, P less than 0.02; chi 2 = 7.85, P less than 0.001 respectively). Patients showing oscillation demonstrated significantly more tertiary contractions (17/21) and low amplitude waves (12/21) compared with 20/81 and 10/81 patients without oscillation (chi 2 = 20.47, P less than 0.001; chi 2 = 17.22, P less than 0.001 respectively). The solid bolus oesophageal transit test provides an objective screening test of specific oesophageal motility disorders and should be performed before oesophageal manometry.
Br J Surg 1987 Dec
PMID:The solid bolus oesophageal egg transit test: its manometric interpretation and usefulness as a screening test. 282 34


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