• Title/Summary/Keyword: Esophageal achalasia

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Surgical Treatment of Esophageal Achalasia -Report of 4 Cases- (Achalasia의 외과적 치료)

  • Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.12 no.2
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    • pp.75-81
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    • 1979
  • Eophagocardiomyotomy (modi/red Heller procedure) is a widely accepted operation for relief of dysphagia in patients with esophageal achalasia. But patients with advanced achalasia were more likely to get poorer results from a modified Ileller myotomy hecause of the dependent pouch that creates an angulation at the junction of thick-walled dilated esophagus with the thin walled aganglionic segment and hinders complete emptlllg. Thorhjarnarson(1975) prposcd the method including truncal vagectomy and pyloroplasty. Vagectomy and pyloroplasty should lesson the severity of acid-peptic esophagitis, if reflux should occur postoperatively. Here we presented 4 cases esophageal achalasia treated by modified Heller operation of 3 cases and one case of Thorbjarnarson method. All postoperative results are good.

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Achalasia Previously Diagnosed as Gastroesophageal Reflux Disease by Relying on Esophageal Impedance-pH Monitoring: Use of High-Resolution Esophageal Manometry in Children

  • Pyun, Jung Eun;Choi, Da Min;Lee, Jung Hwa;Yoo, Kee Hwan;Shim, Jung Ok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.55-59
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    • 2015
  • Gastroesophageal reflux disorder (GERD) is the most common esophageal disorder in children. Achalasia occurs less commonly but has similar symptoms to GERD. A nine-year old boy presented with vomiting, heartburn, and nocturnal cough. The esophageal impedance-pH monitor revealed nonacidic GERD (all-refluxate clearance percent time of 20.9%). His symptoms persisted despite medical treatment for GERD, and he was lost to follow up. Four years later, he presented with heartburn, solid-food dysphagia, daily post-prandial vomiting, and failure to thrive. Endoscopy showed a severely dilated esophagus with candidiasis. High-resolution manometry was performed, and he was diagnosed with classic achalasia (also known as type I). His symptoms resolved after two pneumatic dilatation procedures, and his weight and height began to catch up to his peers. Clinicians might consider using high-resolution manometry in children with atypical GERD even after evaluation with an impedance-pH monitor.

Surgical Treatment of Achalasia : A report of 13 cases (Achalasia 의 수술요법 -13례 보고-)

  • Jo, Dae-Yun;Yang, Gi-Min;Rho, Joon-Rhyang
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.470-474
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    • 1980
  • Achalasia is a neurogenic esophageal disorder, characterized by incomplete relaxation of the gastroesophageal sphincter in response to deglutition and absence of peristalsis from the body of the esophaugs. Because there is no known method by which esophageal peristalsis can be restored, therapy is directed toward the relief of dital esophageal obstruction. During the period of June 1965 to September 1980, 13 cases of achalasia were operated at the Department of Thoracic SUrgery, Seoul Natonal University Hospital. 1. Among 13 cases, 5 were male and 8 were female. 2. Esophagomyotomy was performed in 12 cases, and 1 case was treated with transverse suture of lower esophagus after longitudinal incision. 3. There was no operative mortality, but 2 cases subsequently underwent esophagogastrostomy after esophagomyotomy. 4. One of 13 cases was combined with mongolism.

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Idiopathic Concurrent Gastric Cardiac and Pyloric Achalasia in a Dog (개에서 특발성 위 분문부 및 유문부 괄약근이완무력증 1례)

  • Lee, Ki-Chang;Shin, Seong-Ho;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.371-374
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    • 2006
  • A 4-month-old, intact male, Tosa with a history of a regurgitation, vomiting, and weight loss for three weeks was presented to Animal Medical Center, Chonbuk National University. In Serial plain radiographs, a severely distended stomach was seen and ultrasonogram revealed a nonfunctional pylorus with normal layer comparable with an obstruction of pyloric region by pyloric achalasia. An esophagram and endoscopy revealed normal peristalsis with failure of the lower esophageal sphincter to open, supporting the diagnosis of esophageal achalasia. Megaesophagus was observed on reradiograph and esophagram 11 days later. The clinical signs and esophageal dilation were resolved without resorting to any treatment.

Surgical Treatment of Achalasia of the Esophagus -Report of 9 Cases Performed Modified Heller Operation- (Achalasia 의 외과적 치료 -Modified Heller Operation을 시행한 9례의 관찰성적-)

  • 이호일
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.53-60
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    • 1968
  • Achalasia is a functional disorder of a short segment of the lower esophagus showing obstruction of the esophagogastric junction. Dysphagia. regurgitation and weight loss are outstanding features,however, complicated pulmonary troubles aspiration pneumonitis, bronchiectasis, lung abscess etc. --are sometimes more apparent than the disease entity in children though achalasia is rarely encountered in children. During the period of January, 1961, to May, 1968, the authors experienced 9 cases of achalasia of the esophagus in Chest Surgery Department,N.M.C. 1. Seven of nine were male and four were under 5 years of age. 2. So-called symptoms triad noted in almost every case, and 3 of 4 children showed recurrent attacks of pneumonitis. 3. Chest film showed widened superior mediastinum by dilated esophagus in 6 cases, and pulmonary infiltrations in 3 cases of children. 4. Preoperative diagnosis were achalasia,esophageal stricture by rodent-cidal ingestion and suggestive esophageal cancer in 7 cases,one case and remaining one case. respectively. 5. Modified Heller procedure was performed in all cases with definite diagnosis of achalasia at operation table in misdiagnosed 2 cases. 6. Immediate postoperative complications were 2 cases of wound infection and one case of atelectasis and no operative mortality encountered. 7. Seven of nine showed excellent result of operation, and good in one case. Remaining one case failed relieving obstruction and underwent interposition of ileocolonic segment with excellent result.

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Cricopharyngeal Achalasia - A Case Report - (윤상인두근 무이완증)

  • 김재영;박형주;장인성;고정관;이철세;박상흠;이문호
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.432-435
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    • 1998
  • Idiopathic cricopharyngeal achalasia is a rare condition that produces oropharyngeal dysphagia. It is caused by spasm of the cricopharyngeus and inability to relax with swallowing. A prominent muscle bar at the upper esophageal sphincter is a typical finding of the esophagogram. Cricopharyngeal myotomy is the treatment of choice. We report a case of cricopharyngeal myotomy for 61-year-old female patient.

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Achalasia treated with mercury dilation (Mereury 확장으로 치유된 achalasia)

  • 이상호;홍래복
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.90.1-90
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    • 1976
  • Achalasia is a disorder of the esophagus. Characterized principally by dysphagia resulting from lack of effective forward peristaltic movement of the body of the esophagus and failure of relaxation of the lower esophageal segment. It is probably caused by an extra-esophageal vagal lesion, either of the peripheral vagus nerve or of its dorsal motor nucleus. Recently the author had experienced one case of achalasia which was diagnosed by the esophagogram and esophagoscopic examination.

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A case report of Successful Laparascopic Myotomy for Achalasia (식도이완불능증의 복강경 수술)

  • 황성욱;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.157-160
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    • 2002
  • Recently, video-assisted surgical approaches for achalasia have been adopted by many surgeons. Many reports showed that the minimal invasive video-assisted operations for Ihe achalasia revealed such good results as the conventional operations via thoracotomy. In some studies, among the minimal invasive video assisted surgeries for achalasia, the laparascopic assisted operations have some advantages mainly in respect to patient satisfaction over the thoracoscopic assisted surgeries. In this case, the patient had not responded to repeated balloon dilatation, and we made 5 small incisions over the abdominal wall and performed an esophageal myotomy and partial anterior fundoplication by laparascopic guide. The patient's symptoms were almost relieved, and the postoperative radiologic findings were satisfactory.

Submucosal endoscopy: the present and future

  • Zaheer Nabi;Duvvur Nageshwar Reddy
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.23-37
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    • 2023
  • Submucosal endoscopy or third-space endoscopy utilizes the potential space between the mucosal and muscularis layers of the gastrointestinal tract to execute therapeutic interventions for various diseases. Over the last decade, endoscopic access to the submucosal space has revolutionized the field of therapeutic endoscopy. Submucosal endoscopy was originally used to perform endoscopic myotomy in patients with achalasia cardia, and its use has grown exponentially since. Currently, submucosal endoscopy is widely used to resect subepithelial tumors and to manage refractory gastroparesis and Zenker's diverticulum. While the utility of submucosal endoscopy has stood the test of time in esophageal motility disorders and subepithelial tumors, its durability remains to be established in conditions such as Zenker's diverticulum and refractory gastroparesis. Other emerging indications for submucosal endoscopy include esophageal epiphrenic diverticulum, Hirschsprung's disease, and esophageal strictures not amenable to conventional endoscopic treatment. The potential of submucosal endoscopy to provide easy and safe access to the mediastinum and peritoneal spaces may open doors to novel indications and rejuvenate the interest of endoscopists in natural orifice transluminal endoscopic surgery in the future. This review focuses on the current spectrum, recent updates, and future direction of submucosal endoscopy in the gastrointestinal tract.

Cricopharyngeal achalasia in an old dog

  • Im, Ji-Eun;Yoon, Hun-Young;Kim, Seung-Gon;Lee, Chang-Min;Eom, Ki-Dong;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.54 no.4
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    • pp.261-263
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    • 2014
  • A 10-year-old castrated male papillon presented with nasal discharge, coughing and chronic dysphagia. On physical examination, the dog exhibited sneezing, gurgling and movement of the throat with repeated attempts to swallow fluids. A diagnosis of cricopharyngeal achalasia (CPA) was made based on video fluoroscopic demonstration of failure of relaxation of the upper esophageal sphincter. This report describes the diagnosis of CPA in an old dog, which is rarely diagnosed in older animals.