Menezes M A, Andolfi C, Herbella F A M, Patti M G
Department of Surgery, Escola Paulista de Medicina, Federal University of São Paulo, Sao Paulo, Brazil.
Department of Surgery, University of Chicago, Illinois, USA.
Dis Esophagus. 2017 May 1;30(5):1-4. doi: 10.1093/dote/dow008.
Achalasia may present in a non-advanced or an advanced (end stage) stage based on the degree of esophageal dilatation. Manometric parameters and esophageal caliber may be prognostic for the outcome of treatment. The correlation between manometry and disease stage has not been yet fully studied. This study aims to describe high-resolution manometry findings in patients with achalasia and massive dilated megaesophagus. Eighteen patients (mean age 61 years, 55% females) with achalasia and massive dilated megaesophagus, as defined by a maximum esophageal dilatation >10 cm at the barium esophagram, were studied. Achalasia was considered secondary to Chagas' disease in 14 (78%) of the patients and idiopathic in the remaining. All patients underwent high-resolution manometry. Upper esophageal sphincter was hypotonic and had impaired relaxation in the majority of patients. Aperistalsis was seen in all patients with an equal distribution of Chicago type I and type II. No type III was noticed. Lower esophageal sphincter did not have a characteristic manometric pattern. In 50% of the cases, the manometry catheter was not able to reach the stomach. Our results did not show a manometric pattern in patients with achalasia and massive dilated esophagus.
根据食管扩张程度，贲门失弛缓症可表现为非晚期或晚期（终末期）。测压参数和食管管径可能对治疗结果具有预后价值。测压与疾病分期之间的相关性尚未得到充分研究。本研究旨在描述贲门失弛缓症合并巨大扩张型巨食管患者的高分辨率测压结果。对18例贲门失弛缓症合并巨大扩张型巨食管患者（平均年龄61岁，55%为女性）进行了研究，这些患者在钡餐食管造影中最大食管扩张>10 cm。14例（78%）患者的贲门失弛缓症被认为继发于恰加斯病，其余为特发性。所有患者均接受了高分辨率测压。大多数患者的食管上括约肌张力低下且松弛受损。所有患者均出现无蠕动，芝加哥I型和II型分布均等。未发现III型。食管下括约肌没有特征性的测压模式。在50%的病例中，测压导管无法到达胃部。我们的结果未显示贲门失弛缓症合并巨大扩张食管患者的测压模式。
