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An Evidence of Esophageal Decompensation in Patients With Achalasia in the View of Its Subtype: A Retrospective Study

Authors
 Kwangwon Rhee  ;  Hanho Jeon  ;  Jie-Hyun Kim  ;  Young Hoon Yoon  ;  Hyojin Park  ;  Sang In Lee 
Citation
 JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY, Vol.19(3) : 319-323, 2013 
Journal Title
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
ISSN
 2093-0879 
Issue Date
2013
Keywords
Esophageal achalasia ; Manometry ; Radionuclide imaging
Abstract
Background/Aims
Achalasia is a primary motility disorder of esophagus. Many parameters represent esophageal function and morphologic changes, but their interrelationship is not yet established. We hypothesized that esophageal body would need to generate unusual pressure to empty the food bolus through the non-relaxing lower esophageal sphincter in patients with achalasia; therefore, higher is the residual lower esophageal sphincter pressure, greater would be the contraction pressure in the esophageal body in these patients. To verify the hypothesis, correlations among parameters from esophageal manometry, esophagography and esophageal transit study had been investigated.
Methods
A retrospective review of 34 patients was conducted. Resting lower esophageal sphincter pressure and contraction pressure of esophageal body were obtained from conventional esophageal manometry. Diameter of esophageal body was measured from barium column under esophagography. Radionuclide imaging was performed to assess the esophageal transit, designated as R, which was the residual radioactivity at 30 seconds after ingesting radioactive isotope.
Results
In vigorous achalasia group, contraction pressure of esophageal body was negatively correlated to dilated diameter of esophageal body ( = 0.025, correlation coefficient = -0.596). Esophageal transit was more delayed as dimensions of esophageal body increased in classic achalasia group ( = 0.039, correlation coefficient = 0.627).
Conclusions
Diameter of esophageal body in classic achalasia was relatively wider than that of vigorous achalasia group and the degree of delayed esophageal transit was proportionate to the luminal widening. Patients with vigorous achalasia had narrower esophageal lumen and relatively shorter transit time than that of classic achalasia group. Proper peristalsis is not present in achalasia patients but remaining neuromuscular activity in vigorous achalasia patients might have caused the luminal narrowing and shorter transit time.
Files in This Item:
T201303059.pdf Download
DOI
10.5056/jnm.2013.19.3.319
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Rhee, Kwang Won(이광원)
Jeon, Han Ho(전한호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87760
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