López Gastón A R, Andrusch A, Tiberio D, Curcio A
Servicio de Gastroenterología, Hospital Militar Central Cir My Dr. Cosme Argerich, Buenos Aires, República Argentina.
Acta Gastroenterol Latinoam. 1994;24(1):15-21.
The esophagus is source of several kinds of painful sensibility. Esophageal sensoriality follows the general visceral sensibility laws with some individual differences. We have investigated the areas of pain projection induced by a progressive balloon distension in 2 cm scales from 38 to 22 cm. of the dental row. It was registered the number of painful responses in everyone of the 13 frontal zones an 10 dorsal zones in which the chest was divided. Epigastrium and the base of neck were included. It was considered the first patient's symptom or until a maximum of 15 ml. of air (diameter = 3.2 cm.) 101 patients were examined. 1153 responses in the all 9 stimulated levels were obtained. 93.8% were in frontal zones, and 82.4% of them in median areas (from epigastrium to neck). There were not differences between both sexes. The inferior esophagus was significantly less sensible than the superior esophagus. The number of projections to the superior chest was proportionally larger. There were individual patterns which could be usefull in a particular patient.
a) the esophagus is not equally sensible in its whole extension; b) the metameric projection is multiple and predominates in frontal areas; c) the existence of "trigger zones" obligate to examine the whole extension of the esophagus when intraesophageal distension of a balloon is used as a diagnostic test.
食管是多种疼痛感觉的来源。食管感觉遵循一般内脏感觉规律，但存在一些个体差异。我们研究了从齿列38厘米至22厘米处每隔2厘米逐步进行球囊扩张所诱发的疼痛投射区域。记录了胸部被划分的13个前部区域和10个背部区域中每个区域的疼痛反应数量。上腹部和颈部基部也包括在内。以患者的首个症状或直至最多15毫升空气（直径 = 3.2厘米）为考量标准，对101例患者进行了检查。在所有9个刺激水平上共获得1153次反应。93.8%的反应出现在前部区域，其中82.4%出现在正中区域（从上腹部到颈部）。男女之间无差异。食管下段的敏感性明显低于食管上段。投射到上胸部的数量比例更大。存在个体模式，这对特定患者可能有用。
a）食管在其整个长度上的敏感性并不相同；b）节段性投射是多样的，且在前部区域占主导；c）当使用球囊食管内扩张作为诊断测试时，“触发区”的存在使得有必要检查食管的整个长度。
