Torres-Aguilera M, Remes-Troche J M, Roesch-Dietlen F, Vázquez-Jiménez J G, De la Cruz-Patiño E, Grube-Pagola P, Ruiz-Juárez I
Facultad de Medicina Miguel Alemán Valdés, Veracruz, México.
Rev Gastroenterol Mex. 2011 Jul-Sep;76(3):199-208.
The indeterminate chronic or "asymptomatic" phase of Trypanosoma cruzi (Chagas' disease) infection is characterized by the absence of gastrointestinal symptoms, and has an estimated duration of 20 to 30 years. However, the intramural denervation that induces dysfunction of the gastrointestinal tract is progressive. Recently, epidemiological studies have shown that the seroprevalence for this infection in our area ranges between 2% and 3% of the population.
To detect the presence of esophageal motor disorders in asymptomatic individuals chronically infected with Trypanosoma cruzi using standard esophageal manometry.
A cross sectional study in 28 asymptomatic subjects (27 men, age 40.39 ± 10.79) with serological evidence of infection with Trypanosoma cruzi was performed. In all cases demographic characteristics, gastrointestinal symptoms and esophageal motility disorders using conventional manometry were analyzed.
In this study 54% (n = 15) of asymptomatic subjects had an esophageal motor disorder: 5 (18%) had nutcracker esophagus, 5 (18%) nonspecific esophageal motor disorders, 3 (11%) hypertensive lower esophageal sphincter (LES), 1 (4%) an incomplete relaxation of the LES and 1 (4%) had chagasic achalasia.
More than half of patients that course with Chagas' disease in the indeterminate phase and that are apparently asymptomatic have impaired esophageal motility. Presence of hypertensive LES raises the possibility that this alteration represents an early stage in the development of chagasic achalasia.
克氏锥虫（恰加斯病）感染的不确定慢性期或“无症状”期的特征是没有胃肠道症状，估计持续时间为20至30年。然而，导致胃肠道功能障碍的壁内去神经支配是渐进性的。最近，流行病学研究表明，我们地区这种感染的血清阳性率在人群的2%至3%之间。
使用标准食管测压法检测慢性感染克氏锥虫的无症状个体中食管运动障碍的存在情况。
对28名有克氏锥虫感染血清学证据的无症状受试者（27名男性，年龄40.39±10.79）进行了横断面研究。在所有病例中，分析了人口统计学特征、胃肠道症状以及使用传统测压法检测的食管运动障碍情况。
在本研究中，54%（n = 15）的无症状受试者存在食管运动障碍：5名（18%）患有胡桃夹食管，5名（18%）患有非特异性食管运动障碍，3名（11%）食管下括约肌（LES）高压，1名（4%）LES不完全松弛，1名（4%）患有恰加斯失弛缓症。
超过一半处于恰加斯病不确定期且明显无症状的患者存在食管运动功能受损。LES高压的存在增加了这种改变代表恰加斯失弛缓症发展早期阶段的可能性。
