Ott D J, Donati D, Wu W C, Chen M Y, Gelfand D W
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27103.
Gastrointest Radiol. 1991 Fall;16(4):279-82. doi: 10.1007/BF01887367.
Radiographic evaluation of the lower esophagus was done immediately after pneumatic dilatation using the Rigiflex dilator in 34 patients (24 men, 10 women; mean age, 55 years) with achalasia. The dilator was positioned across the esophagogastic junction using fluoroscopy and the balloon was inflated for 1 min. The esophagus was intubated and injected sequentially with water-soluble and barium contrast materials. Radiographic analysis included changes in the appearance of the caliber and contour of the esophagogastric junction, rate of esophageal emptying, and presence of complications. In 23 patients with predilatation esophagrams, the mean esophagogastric junction caliber increased from 4.7-7.6 mm following dilatation. The postdilatation esophagrams in 33 patients showed a smooth contour in 22 (67%) and immediate esophageal emptying in 26 (79%). Esophageal perforation occurred in one (3%) patient and intramural hematoma in one (3%). Clinical follow-up (mean, 7 months) was available in 29 patients and 23 (79%) had symptomatic improvement. Five of the six patients who did not improve clinically all had previous Heller myotomy, pneumatic dilatation, or both.
对34例贲门失弛缓症患者（24例男性，10例女性；平均年龄55岁）使用Rigiflex扩张器进行气囊扩张后，立即对其食管下段进行了影像学评估。利用荧光镜检查将扩张器放置于食管胃交界处，气囊充气1分钟。对食管进行插管，并依次注入水溶性造影剂和钡剂。影像学分析包括食管胃交界处管径和轮廓的外观变化、食管排空率以及并发症的存在情况。在23例扩张术前有食管造影的患者中，扩张后食管胃交界处平均管径从4.7毫米增加到7.6毫米。33例患者扩张术后的食管造影显示，22例（67%）轮廓光滑，26例（79%）食管立即排空。1例（3%）患者发生食管穿孔，1例（3%）出现壁内血肿。29例患者获得了临床随访（平均7个月），其中23例（79%）症状改善。6例临床未改善的患者中，有5例既往曾行赫勒肌切开术、气囊扩张术或两者均有。
