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食管贲门失弛缓症的评估:从症状到芝加哥分类法

EVALUATION OF ESOPHAGEAL ACHALASIA: FROM SYMPTOMS TO THE CHICAGO CLASSIFICATION.

作者信息

Laurino-Neto Rafael Melillo, Herbella Fernando, Schlottmann Francisco, Patti Marco

机构信息

Departamento de Cirurgia, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP.

Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.

出版信息

Arq Bras Cir Dig. 2018;31(2):e1376. doi: 10.1590/0102-672020180001e1376. Epub 2018 Jul 2.

Abstract

INTRODUCTION

The diagnosis of achalasia may be suggested by clinical features but a complete work-up is required not only to confirm the diagnosis but also to grade the disease by severity or clinical subtype.

OBJECTIVE

To review the current evaluation of esophageal achalasia and its correct comprehension.

METHOD

The literature review was based on papers published on Medline/Pubmed, SciELO and Lilacs, crossing the following headings: "esophageal achalasia"; "deglutition disorders"; "diagnostic techniques", "digestive system"; "endoscopy, digestive system"; "manometry".

RESULTS

The diagnosis of achalasia is suggested by clinical features but is not sufficient to distinguish this from other esophageal disease. It must be confirmed by further diagnostic tests, such as esophagogastroduodenoscopy, barium swallow and manometry. Recent advances in diagnostic methods, including high resolution manometry might even help predicting outcome or selected more appropriate procedures to treat the disease.

CONCLUSION

A detailed and systematic study of achalasia patients allows not only a correct diagnosis but also contributes to therapeutic decision making and prognosis.

摘要

引言

贲门失弛缓症的诊断可通过临床特征提示,但需要进行全面检查,这不仅是为了确诊,也是为了根据疾病的严重程度或临床亚型进行分级。

目的

综述目前对食管贲门失弛缓症的评估及其正确理解。

方法

文献综述基于发表在Medline/Pubmed、SciELO和Lilacs上的论文,检索词包括:“食管贲门失弛缓症”;“吞咽障碍”;“诊断技术”;“消化系统”;“消化系统内镜检查”;“测压法”。

结果

贲门失弛缓症的诊断可通过临床特征提示,但不足以将其与其他食管疾病区分开来。必须通过进一步的诊断测试来确诊,如食管胃十二指肠镜检查、吞钡检查和测压法。诊断方法的最新进展,包括高分辨率测压法,甚至可能有助于预测预后或选择更合适的治疗方法。

结论

对贲门失弛缓症患者进行详细而系统的研究,不仅能做出正确诊断,还有助于治疗决策和预后判断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be9e/6044194/350d4b277fde/0102-6720-abcd-31-02-e1376-gf1.jpg

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