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Radiographic and manometric correlation in achalasia with apparent relaxation of the lower esophageal sphincter

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Abstract

We compared the clinical, radiographic, and manometric findings in 10 patients with atypical achalasia showing complete lower esophageal sphincter (LES) relaxation to 39 patients with classic achalasia (i.e., incomplete LES relaxation). Those with atypical achalasia were younger (46.1 vs 60.6 years), had dysphagia of shorter duration (18.7 vs 45.7 mos), had lost less weight (8.2 vs 21.5 lbs), and had less esophageal dilatation (2.8 vs 3.9 cm). However, the mean LES pressures (34.5 vs 37.7 mmHg) and the esophagogastric junction calibers (4.5 vs 4.8 mm) were similar. Radionuclide esophageal emptying studies were done in 15 patients (6 with atypical achalasia; 9 with classic achalasia) and were abnormal in all. Most patients in both groups (90 and 92%) responded well to pneumatic dilatation. We conclude that achalasia with apparent LES relaxation may represent an early form of this motor disorder and that the radiographic findings remain characteristic except for less dilatation of the esophagus.

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References

  1. Cohen S: Motor disorders of the esophagus.N Engl J Med 301:184–192, 1979

    Google Scholar 

  2. Blackwell JN, Castell DO: Motility disorders of the lower esophagus.Surv Dig Dis 1:157–168, 1983

    Google Scholar 

  3. Katz PO, Castell DO: Review: esophageal motility disorders.Am J Med Sci 290:61–69, 1985

    Google Scholar 

  4. Castell DO: Achalasia and diffuse esophageal spasm.Arch Intern Med 136:571–579, 1976

    Google Scholar 

  5. Margulis AR, Koehler RE: Radiologic diagnosis of disordered esophageal motility.Radiol Clin North Am 14:429–439, 1976

    Google Scholar 

  6. Stewart ET: Radiographic evaluation of the esophagus and its motor disorders.Med Clin North Am 65:1173–1194, 1981

    Google Scholar 

  7. Dodds WJ: Motility disorders. In Margulis AR Burhenne HJ (eds):Alimentary Tract Radiology (vol 1, 3rd ed). St Louis, MO: CV Mosby, 1983, pp 538–553

    Google Scholar 

  8. Katz PO, Richter JE, Cowan R, Castell DO: Apparent complete lower esophageal sphincter relaxation in achalasia.Gastroenterology 90:978–983, 1986

    Google Scholar 

  9. Richter JE, Wu WC, Johns DN et al.: Esophageal manometry in 95 healthy adult volunteers: variability of pressures with age and frequency of “abnormal” contractions.Dig Dis Sci 32:583–592, 1987

    Google Scholar 

  10. Ott DJ: Radiologic evaluation of the esophagus. In Castell DO Johnson LF (eds):Esophageal Function in Health and Disease. New York: Elsevier Biomedical, 1983, pp 211–235

    Google Scholar 

  11. Cohen BR: Cardiospasm in achalasia: demonstration of an abnormally elevated esophagogastric sphincter pressure with patient relaxation on swallowing.Gastroenterol Res Forum 48:864, 1965

    Google Scholar 

  12. Chobanian SJ, Benjamin SB, Spurling TJ, Cattau E, Castell DO: Characterization of lower esophageal sphincter relaxation in normals (abstract).Clin Res 30:723A, 1982

    Google Scholar 

  13. Dodds WJ, Stewart ET, Hogan WJ, Stef JJ, Arndorfer RC: Effect of esophageal movement on intraluminal esophageal pressure recording.Gastroenterology 67:592–600, 1974

    Google Scholar 

  14. Dodds WJ: Instrumentation and methods for intraluminal esophageal manometry.Arch Intern Med 136:515–523, 1976

    Google Scholar 

  15. Dent J, Chir B: A new technique for continuous sphincter pressure measurement.Gastroenterology 71:263–267, 1976

    Google Scholar 

  16. Vantrappen G, Janssens J, Hellemans J, Coremans G: Achalasia, diffuse esophageal spasm and related motility disorders.Gastroenterology 76:450–457, 1979

    Google Scholar 

  17. Hogan WJ, Caflisch CR, Winship DH: Unclassified esophageal motor disorders simulating achalasia.Gut 10:234–240, 1969

    Google Scholar 

  18. Castell DO: The spectrum of esophageal motility disorders.Gastroenterology 76:639–640, 1979

    Google Scholar 

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Ott, D.J., Richter, J.E., Chen, Y.M. et al. Radiographic and manometric correlation in achalasia with apparent relaxation of the lower esophageal sphincter. Gastrointest Radiol 14, 1–5 (1989). https://doi.org/10.1007/BF01889144

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  • DOI: https://doi.org/10.1007/BF01889144

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