Penagini R, Bartesaghi B, Bianchi P A
Cattedra di Patologia Medica III, University of Milan.
Panminerva Med. 1992 Apr-Jun;34(2):81-4.
Two cases of dysphagia, in which radiology led to an incorrect diagnosis, are described. In case I the X-ray barium swallow showed only minor oesophageal dilatation with no apparent delay in emptying or abnormality of the cardias, yet achalasia was diagnosed by oesophageal manometry. In case 2, although the barium swallow strongly suggested achalasia, manometry showed a less severe motility disorder characterized by lower oesophageal sphincter dysfunction and normal peristalsis. Correct diagnosis obtained with manometry was supported by the different clinical course of the two patients during a 2 year follow up. Oesophageal manometry should always be performed when radiology and/or the patient's history suggest the presence of a motility disorder of the oesophagus since a correct diagnosis is essential for appropriate treatment and follow-up.
本文描述了两例吞咽困难病例，其中放射学检查导致了错误诊断。病例1中，X线吞钡检查仅显示食管轻度扩张，排空无明显延迟，贲门无异常，但食管测压诊断为贲门失弛缓症。病例2中，尽管吞钡检查强烈提示贲门失弛缓症，但测压显示为较轻的动力障碍，表现为食管下括约肌功能障碍和正常蠕动。在两年的随访中，两名患者不同的临床病程支持了通过测压获得的正确诊断。当放射学检查和/或患者病史提示存在食管动力障碍时，应始终进行食管测压，因为正确诊断对于适当的治疗和随访至关重要。
