Le Blanc I, Scotte M, Michot F, Tenière P
Service de Chirurgie Générale et Digestive, Hôtel-Dieu de Rouen.
Ann Chir. 1992;46(3):255-7.
A pulsion diverticulum of the mid-thoracic oesophagus was resected because of severe dysphagia. A subdiverticular myotomy was associated for the treatment of non-propagated oesophageal contractions, without oesophageal low-sphincter abnormalities. Three months post-operatively, the dysphagia was still present and manometry showed the absence of lower sphincter relaxation after 45 percent of deglutitions; a lower oesophageal sphincter myotomy was performed, resulting in correction of the dysphagia and of the sphincter relaxation abnormalities. The deficit of the inhibitory nervous mechanism, responsible for abnormalities of lower oesophageal sphincter relaxation, was present in the entire intramural oesophageal plexus, but, was not symptomatic at the level of the IOS prior to resection of the diverticulum.
一名因严重吞咽困难而切除胸段中段食管膨出憩室的患者。为治疗非传播性食管收缩，在憩室下方进行了肌切开术，且食管下括约肌无异常。术后三个月，吞咽困难仍然存在，测压显示45%的吞咽后食管下括约肌无松弛；遂进行了食管下括约肌肌切开术，从而纠正了吞咽困难和括约肌松弛异常。负责食管下括约肌松弛异常的抑制性神经机制缺陷存在于整个食管壁内神经丛中，但在憩室切除术前，在食管下括约肌水平并无症状。
