Eckardt V F, Köhne U, Junginger T, Westermeier T
Gastroenterology Institute Wiesbaden, Germany.
Dig Dis Sci. 1997 Mar;42(3):580-5. doi: 10.1023/a:1018855327960.
This study investigates whether the frequently delayed diagnosis of achalasia is attributable to atypical symptoms, misleading diagnostic features, or the number of physicians consulted. Eighty-seven consecutive patients with newly diagnosed achalasia were prospectively investigated with the use of structured interviews as well as manometric, endoscopic, and radiographic studies. The mean duration of symptoms was 4.7 +/- 6.4 years. Quality and intensity of symptoms had no effect on early diagnosis. Among different radiographic and manometric features, only the width of the gastric cardia showed a significant correlation with a delay in diagnosis (P < 0.01). However, the most significant association was found between the duration of symptoms prior to considering the diagnosis of achalasia and the number of unsuccessful physician consultations (P = 0.001). We conclude that the frequent delay in the diagnosis of achalasia is not due to an atypical clinical presentation of this disease but rather to misinterpretation of typical findings by the physician consulted.
本研究调查贲门失弛缓症的诊断经常延迟是否归因于非典型症状、误导性诊断特征或咨询医生的数量。对87例新诊断为贲门失弛缓症的连续患者进行了前瞻性研究，采用结构化访谈以及测压、内镜和影像学检查。症状的平均持续时间为4.7±6.4年。症状的质量和强度对早期诊断没有影响。在不同的影像学和测压特征中，只有贲门宽度与诊断延迟有显著相关性（P<0.01）。然而，在考虑贲门失弛缓症诊断之前的症状持续时间与医生咨询未成功的次数之间发现了最显著的关联（P = 0.001）。我们得出结论，贲门失弛缓症诊断的频繁延迟不是由于该疾病的非典型临床表现，而是由于咨询医生对典型发现的错误解读。
