Manometric Studies in Achalasia of the Cardia, Before and After Pneumatic Dilations

Vantrappen, Gaston; Ge, Vangoidsenhoven; S, Verbeke; Vandenberghe, Gm; Vanderbroucke, J

doi:10.1016/s0016-5085(19)34864-4

Cited by 49 publications

(6 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The LES displays high pressure at rest and fails to relax, or relaxes only partially with swallowing (Figure 1 ). Up to 40% of the patients with achalasia have normal LES pressure (10–40 mm Hg); however, low pressure LES is not seen in untreated achalasia patients [ 47 ].…”

Section: Diagnosis and Differential Diagnosismentioning

confidence: 99%

Idiopathic (primary) achalasia

Farrokhi

Vaezi

2007

Orphanet J Rare Dis

View full text Add to dashboard Cite

Idiopathic achalasia is a primary esophageal motor disorder characterized by esophageal aperistalsis and abnormal lower esophageal sphincter (LES) relaxation in response to deglutition. It is a rare disease with an annual incidence of approximately 1/100,000 and a prevalence rate of 1/10,000. The disease can occur at any age, with a similar rate in men and women, but is usually diagnosed between 25 and 60 years. It is characterized predominantly by dysphagia to solids and liquids, bland regurgitation, and chest pain. Weight loss (usually between 5 to 10 kg) is present in most but not in all patients. Heartburn occurs in 27%-42% of achalasia patients. Etiology is unknown. Some familial cases have been reported, but the rarity of familial occurrence does not support the hypothesis that genetic inheritance is a significant etiologic factor. Association of achalasia with viral infections and auto-antibodies against myenteric plexus has been reported, but the causal relationship remains unclear. The diagnosis is based on history of the disease, radiography (barium esophagogram), and esophageal motility testing (esophageal manometry). Endoscopic examination is important to rule out malignancy as the cause of achalasia. Treatment is strictly palliative. Current medical and surgical therapeutic options (pneumatic dilation, surgical myotomy, and pharmacologic agents) aimed at reducing the LES pressure and facilitating esophageal emptying by gravity and hydrostatic pressure of retained food and liquids. Although it cannot be permanently cured, excellent palliation is available in over 90% of patients.

show abstract

Section: Diagnosis and Differential Diagnosismentioning

confidence: 99%

Idiopathic (primary) achalasia

Farrokhi

Vaezi

2007

Orphanet J Rare Dis

View full text Add to dashboard Cite

show abstract

“…The manometric studies were performed with the use of three to six water-filled, non-perfused opentip catheters. The technique of intraluminal pressure measurements and the manometric observations in patients with achalasia have already been described (Vantrappen, Van Goidsenhoven, Van den Berghe, Verbeke, and Vandenbroucke, 1963). The resting pressures in the lower oesophageal sphincter were used as a guide for the treatment by pneumatic dilatation; these pressures were within the normal range in all patients before treatment (mean endexpiratory pressure 5.6 ± 0.68 mm Hg at 0.5 cm above the 'diaphragmatic hiatus').…”

mentioning

confidence: 99%

Treatment of achalasia with pneumatic dilatations

Vantrappen¹,

Hellemans²,

Deloof³

et al. 1971

Gut

195

View full text Add to dashboard Cite

SUMMARY During the last 13 years 264 unselected patients with achalasia have been treated solely by the technique of pneumatic dilatation. The principle of the method was to continue the series of consecutive dilatations until the result was satisfactory. This paper reports the late results in 138 patients who were treated more than three years ago (3-13 years; mean 6.6 years). The results were evaluated by somebody who had not before been involved in the treatment of achalasia. The evaluation was based on a personal interview, a standardized radiological examination, and intraluminal pressure measurements.These late results were classified as excellent in 45 %, good in 32%, moderate in 17%, and poor in 6 %. The best results were obtained in patients with a history of five to twenty years and a moderately dilated oesophagus (50-80 mm.). Comparison of the clinical results with the manometric data obtained before, immediately after, and late after treatment indicates that intraluminal pressure measurements may be a useful guide for the treatment of achalasia by pneumatic dilatations.

show abstract

“…The lower oesophageal sphincter has a higher resting pressure than normal, and it fails to relax in response to swallowing. Furthermore the sphincter contracts earlier than normal and this also impairs the nonpropulsive effect of the condition (Vantrappen et al, 1963).…”

Section: Discussionmentioning

confidence: 99%