ABSTRACT
Introducción: La manometría de alta resolución es la prueba de referencia para el estudio de los trastornos motores esofágicos. Objetivo: Determinar la factibilidad de la manometría de alta resolución para el estudio de las características de los trastornos motores esofágicos. Métodos: Se realizó una investigación descriptiva, transversal, en el Centro Nacional de Cirugía de Mínimo Acceso, entre septiembre de 2018 y diciembre de 2019, en 56 pacientes cubanos con diagnóstico de trastorno motor esofágico por manometría de alta resolución, con edades entre 18 y 80 años, que dieron su consentimiento para participar en el estudio. Se excluyeron pacientes con acalasia esofágica y los trastornos menores de la peristalsis. Las variables incluidas fueron: edad, sexo, diagnósticos manométricos y sus características, síntomas, tipos de unión esofagogástrica, diagnósticos imagenológicos o endoscópicos. Para el análisis de los resultados se empleó el porcentaje, medidas de tendencia central y ji cuadrado de Pearson de homogeneidad, con un nivel de significación p 8804; 0,05 y 95 por ciento de confiabilidad. Resultados: Predominó la contractilidad ausente (39,28 por ciento), el sexo femenino (58,9 por ciento) y la disfagia (66,07 por ciento). A la obstrucción al flujo de la unión esofagogástrica correspondió la media de presión de reposo del esfínter esofágico inferior más alta (43,28 mmHg) y la media de la presión de relación integrada por encima de 15 mmHg (38,88 mmHg). El esófago hipercontráctil presentó media de contractilidad distal integrada elevada (5564,25 mmHg/s/cm). Se comprobó la existencia de contracciones rápidas en el espasmo esofágico distal (media de 21,4 cm/ s). Conclusiones: La manometría de alta resolución es factible de ser empleada para el diagnóstico de los trastornos motores esofágicos(AU)
Introduction: High-resolution manometry is the gold standard for the study of esophageal motor disorders. Objective: A descriptive, cross-sectional research was carried out in el Centro Nacional de Cirugía de Mínimo Acceso, between September 2018 and December 2019, in 56 patients, diagnosed with esophageal motor disorder by high-resolution manometry, aged between 18 and 20 years, who gave their consent to participate in the study. Esophageal achalasia and minor peristalsis disorders were excluded. The variables included were: age, sex, manometric diagnoses and their characteristics, symptoms, types of esophagogastric junction, imaging or endoscopic diagnoses. For the analysis of the results, the percentage, measures of central tendency and Pearson's chi square of homogeneity were used, with a level of statistical significance 8804; 0.05 and 95 percent reliability. Development: Absent contractility (39,28 percent), female sex (58,9 percent) and dysphagia (66,07 percent) predominated. The obstruction to the flow of the esophagogastric junction corresponded to the highest mean resting pressure of the lower esophageal sphincter (43,28 mmHg) and the mean integrated pressure ratio above 15 mmHg (38,88 mmHg). The hypercontractile esophagus presented mean high integrated distal contractility (5564,25 mmHg/s/cm). Rapid contractions were found in distal esophageal spasm (mean 21,4 cm/s). Conclusions: High resolution manometry was feasible to be used for the diagnosis of major esophageal motor disorders(AU)
Subject(s)
Humans , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Esophageal Spasm, Diffuse/diagnostic imaging , Deglutition Disorders , Esophageal Sphincter, Lower/diagnostic imaging , Esophageal Diseases/diagnosis , Esophageal Motility Disorders/diagnosis , Epidemiology, Descriptive , Cross-Sectional Studies , Esophagogastric JunctionABSTRACT
Diffuse esophageal spasm, an uncommon esophageal motility disorder, has recently been defined using high-resolution manometry. Patients with distal esophageal spasm usually complain of chest pain or dysphagia. The etiology and pathophysiology of this disorder are poorly known, and treatment options are limited. However, some options to improve symptoms are available, including endoscopic injection of botulinum toxin. Nevertheless, few reports have described the effects of endoscopic injection of botulinum toxin in patients with symptomatic diffuse esophageal spasm with clear endoscopic and high-resolution manometry images. Here, we report a case of diffuse esophageal spasm diagnosed with high-resolution manometry and treated by endoscopic injection of botulinum toxin with good results at the 7-month follow-up.