Cho Yu Kyung
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Gastroenterol. 2020 Oct 25;76(4):179-184. doi: 10.4166/kjg.2020.76.4.179.
Esophageal manometry is the gold standard test for diagnosing primary esophageal motility disorder. With the various metrics of the high-resolution esophageal manometry, the Chicago classification provides a standard approach for the manometric diagnosis of esophageal motor disorders. In the Chicago classification, the esophagogastric junction dysfunction is an important major motor disorder, which includes achalasia subtypes and esophagogastric junction outflow obstruction. Esophagogastric junction outflow obstruction is defined manometrically as normal or weak esophageal peristalsis with incomplete relaxation of the lower esophageal sphincter. It is a heterogeneous disorder and usually has a benign clinical course. The small portion of an esophagogastric junction outflow obstruction is early or variant achalasia. In such cases, treatments directing the lower esophageal sphincter, such as balloon dilatation or per oral endoscopic myotomy, may be necessary. An adjunctive high-resolution manometry provocation test or other esophageal function tests, such as timed barium esophagogram, can help select those patients and predict the treatment outcomes.
食管测压是诊断原发性食管动力障碍的金标准检查。借助高分辨率食管测压的各种指标，芝加哥分类法为食管动力障碍的测压诊断提供了一种标准方法。在芝加哥分类法中，食管胃交界区功能障碍是一种重要的主要动力障碍，包括贲门失弛缓症亚型和食管胃交界区流出道梗阻。食管胃交界区流出道梗阻在测压上被定义为食管蠕动正常或减弱且食管下括约肌不完全松弛。它是一种异质性疾病，通常具有良性的临床病程。食管胃交界区流出道梗阻的一小部分是早期或变异型贲门失弛缓症。在这种情况下，可能需要针对食管下括约肌的治疗，如球囊扩张或经口内镜下肌切开术。辅助性高分辨率测压激发试验或其他食管功能检查，如定时钡剂食管造影，有助于筛选出这些患者并预测治疗效果。
