Benjamin S B, O'Donnell J K, Hancock J, Nielsen P, Castell D O
Dig Dis Sci. 1983 Sep;28(9):775-9. doi: 10.1007/BF01296898.
Symptomatic patients with abnormal esophageal manometry characterized by esophageal peristaltic waves of increased amplitude ("the nutcracker esophagus," NE) have been recognized with increasing frequency. Whether or not this represents a true functional abnormality is unresolved at this time. We have utilized radionuclide transit (RT), a true esophageal function test, to evaluate patients with NE. Eighteen consecutive symptomatic patients with the NE and ten clinically and manometrically normal subjects constituted this study group. RT in normals were 6.8 +/- 0.2 sec (means +/- SE) and 27.6 +/- 3.8 in patients with NE. RT was abnormal in 17/18 patients with NE. Chaotic bolus transit was seen in 11/18 patients with NE but not in normals. The defect was localized to the distal esophagus since transit through the proximal esophagus was not significantly different between the two groups. This defect in RT may be related to spontaneous simultaneous contractions seen in 50% of these patients. Further work will be necessary to determine if NE is a true functional abnormality or a marker for other motility abnormalities such as diffuse esophageal spasm.
有症状且食管测压异常、以食管蠕动波幅度增加为特征（“胡桃夹食管”，NE）的患者已越来越频繁地被发现。目前尚不清楚这是否代表一种真正的功能异常。我们利用放射性核素通过时间（RT）这一真正的食管功能测试来评估NE患者。本研究组包括18例连续的有症状NE患者和10例临床及测压正常的受试者。正常受试者的RT为6.8±0.2秒（均值±标准误），NE患者为27.6±3.8秒。18例NE患者中有17例RT异常。18例NE患者中有11例可见混乱的食团通过，但正常受试者中未见。由于两组间近端食管的通过时间无显著差异，该缺陷定位于食管远端。RT的这一缺陷可能与这些患者中50%出现的自发同步收缩有关。需要进一步研究以确定NE是一种真正的功能异常还是其他动力异常（如弥漫性食管痉挛）的标志物。
