Gelfand M D
Am J Gastroenterol. 1981 Oct;76(4):347-50.
Postvagotomy dysphagia is typically a temporary phenomenon but a small subgroup of patients appear to develop irreversible motility disorders of the esophagus. Two patients are reported with persistent symptomatic esophageal dysfunction demonstrated by modern hydraulic infusion technics. Both initially lost weight rapidly and then stabilized. The distal esophagus of both was greatly dilated but in one patient, lower esophageal sphincter pressure was normal. Aperistalsis with diminished motor activity was present throughout the body of the esophagus. Dysphagia and objective esophageal abnormalities were refractory to dilations with simple mercury bougies in one patient whose condition was improved by treatment with pneumatic dilation. The cause of this unusual complication is unknown but may involve a nonneoplastic form of secondary achalasia.
迷走神经切断术后吞咽困难通常是一种暂时现象，但一小部分患者似乎会发展为不可逆的食管动力障碍。本文报告了2例经现代液压灌注技术证实存在持续性症状性食管功能障碍的患者。两名患者最初体重迅速下降，随后趋于稳定。两名患者的食管远端均明显扩张，但其中一名患者的食管下括约肌压力正常。食管体部出现蠕动消失且运动活性减弱。在一名患者中，单纯水银探条扩张对吞咽困难和客观的食管异常无效，而该患者的病情通过气囊扩张治疗得到改善。这种不寻常并发症的原因尚不清楚，但可能涉及一种非肿瘤性的继发性贲门失弛缓症。
