Hocking M P, Ryckman F C, Woodward E R
Am Surg. 1985 Oct;51(10):563-6.
Peptic stricture of the esophagus and achalasia both cause dysphagia. They are not always readily distinguished by history. The usual workup with upper gastrointestinal x ray and endoscopy may also fail to differentiate the two disorders. Two cases are presented wherein antireflux procedures were mistakenly performed when achalasia was present rather than peptic stricture. Dysphagia was unrelieved and extensive further procedures were required. In a third patient referred for a peptic stricture, manometry revealed the correct diagnosis and heller myotomy provided relief. It is recommended that manometry be performed as a part of the preoperative workup in patients in whom there is any element of dysphagia.
食管消化性狭窄和贲门失弛缓症均会导致吞咽困难。仅凭病史往往难以将二者区分开来。常规的上消化道X线检查和内镜检查也可能无法鉴别这两种疾病。本文介绍了两例病例，在存在贲门失弛缓症而非消化性狭窄的情况下错误地实施了抗反流手术。吞咽困难未得到缓解，还需要进行广泛的进一步治疗。在第三例因消化性狭窄转诊的患者中，测压检查得出了正确诊断，而行贲门肌切开术缓解了症状。建议对有任何吞咽困难因素的患者，在术前检查中进行测压检查。
