Callaway James, Terry Elizabeth
University of Alabama at Birmingham, Birmingham, USA.
Birmingham VA Medical Center, Birmingham, USA.
Abdom Radiol (NY). 2025 Aug;50(8):3457-3466. doi: 10.1007/s00261-024-04793-9. Epub 2025 Jan 31.
Esophageal motility disorders are commonly encountered in the outpatient setting during the evaluation of difficulty swallowing. They typically present with symptoms of dysphagia to solids or liquids, non-cardiac chest pain, or regurgitation. Practitioners rely on both invasive and non-invasive testing to evaluate these complaints, often utilizing endoscopy, fluoroscopic evaluations, and functional esophageal motility testing to characterize symptoms into formal motility disorders, when able. Many of these tests complement each other and more than one is often needed to fully characterize a patient's symptoms. For the past fifteen years, gastroenterologists have primarily used the Chicago Classification for defining esophageal motility disorders by esophageal manometry and this classification scheme has evolved into its 4th iteration. The following paper will review the initial approach to patients presenting with obstructive esophageal symptoms and provide a working knowledge of the Chicago Classification system and additional motility testing used commonly by gastroenterologists.
在评估吞咽困难时，食管动力障碍在门诊中很常见。它们通常表现为固体或液体吞咽困难、非心源性胸痛或反流症状。从业者依靠侵入性和非侵入性测试来评估这些症状，通常在内镜检查、荧光透视评估和功能性食管动力测试的帮助下，尽可能将症状归类为正式的动力障碍。这些测试中的许多相互补充，通常需要不止一项测试才能全面描述患者的症状。在过去的十五年里，胃肠病学家主要使用芝加哥分类法通过食管测压来定义食管动力障碍，并且该分类方案已经发展到第四版。以下文章将回顾对出现食管梗阻症状患者的初步处理方法，并提供芝加哥分类系统的实用知识以及胃肠病学家常用的其他动力测试方法。
