Chartier A, Legallais P, Trappe M, Le Roux C, Marsot-Dupuch K
Service de Gastro-entérologie, Hôpital d'Argenteuil, Argenteuil.
Ann Radiol (Paris). 1994;37(7-8):511-8.
Esophageal dyskinesias are due to various aetiologies and sometimes present with marked clinical symptoms. The barium swallow remains the preferred first-line examination. Upper GI endoscopy and manometry are useful to confirm the functional nature and eliminate any concomitant or secondary mucosal lesions of these motor disorders. The clinical signs of hiatus hernia are essentially due to complications related to gastro-esophageal reflux. They can be asymptomatic or may present in the form of atypical, sometimes extra-gastrointestinal, symptoms. Although conventional radiology allows the diagnosis of hiatus hernia by specifying the type, the morphology and the anatomical relations, it may fail to detect the consequences of gastro-esophageal reflux, especially ulcerated lesions. Upper gastrointestinal endoscopy appears to be the first-line examination of choice for the diagnosis of hiatus hernia. Barium swallow is useful in cases of failure of endoscopy and in the context of preoperative assessment, as these two investigations are often complementary.
食管运动障碍病因多样，有时会出现明显的临床症状。吞钡检查仍是首选的一线检查方法。上消化道内镜检查和测压有助于确认其功能性本质，并排除这些运动障碍伴随的或继发的黏膜病变。食管裂孔疝的临床体征主要是由与胃食管反流相关的并发症引起的。它们可能无症状，也可能表现为非典型症状，有时是胃肠道外症状。尽管传统放射学检查可通过明确类型、形态及解剖关系来诊断食管裂孔疝，但可能无法检测出胃食管反流的后果，尤其是溃疡性病变。上消化道内镜检查似乎是诊断食管裂孔疝的首选一线检查方法。在内镜检查失败的情况下以及术前评估时，吞钡检查很有用，因为这两项检查往往相互补充。
