ABSTRACT
ABSTRACT High resolution manometry changed several esophageal motility paradigms. The 3.0 Chicago Classification defined manometric criteria for named esophageal motility disorders. We present a pictorial atlas of motility disorders. Achalasia types, esophagogastric junction obstruction, absent contractility, distal esophageal spasm, hypercontractile esophagus (jackhammer), ineffective esophageal motility, and fragmented peristalsis are depicted with high-resolution manometry plots.
RESUMO A manometria de alta resolução mudou vários paradigmas da motilidade digestiva. A Classificação de Chicago, na versão 3.0, definiu critérios manométricos para as doenças da motilidade esofagiana. O presente artigo é um atlas das dismotilidades descritas. Tipos de acalásia, obstrução ao nível da junção esofagogástrica, contrações ausentes, espasmo esofagiano distal, esôfago hipercontrátil, motilidade esofagiana ineficaz e peristalse fragmentada são mostradas em traçados de manometria de alta resolução.
Subject(s)
Humans , Esophageal Motility Disorders/diagnostic imaging , Image Interpretation, Computer-Assisted/instrumentation , Esophageal Motility Disorders/classification , Esophageal Achalasia/classification , Esophageal Achalasia/diagnostic imaging , Manometry/instrumentationABSTRACT
Gastroparesia é uma dificuldade no esvaziamento gástrico sem que haja qualquer obstrução mecânica ao livre trânsito gastroduodenal. Trata-se de condição estritamente relacionada à função do estômago, podendo decorrer de distúrbios neural (p. ex.: diabetes mellitus), eletrolítico (p. ex.: hipopotassemia) ou hormonal (p. ex.: hipotireoidismo), dentre outros. Náuseas, vômitos, plenitude pós-prandial e saciedade precoce estão presentes. Não existe exame laboratorial capaz de identificar a gastroparesia, no entanto, eles podem indicar a etiologia da mesma. A radiografia simples de abdome pode demonstrar distensão gástrica; a seriografia gastroduodenal, bem como a endoscopia digestiva, são mais úteis na avaliação de obstrução mecânica. Na atualidade, o padrão ouro para o diagnóstico da gastroparesia é cintilografia gástrica.
Gastroparesis is a difficulty in gastric emptying without any mechanical obstruction gastroduodenal. Is is strictly related to the condition of the stomach, likely to arise of neural disorder (diabetes mellitus), electrolytic (hipopotassemy), or hormone (hypothyroidism), among others. Nausea, vomiting, early postprandial and early satiety are present. There is no laboratory examination identifies the gastroparesis, however, they can indicate the etiology. The simple radiography may demonstrate abdominal distension, gastroduodenal seriography, as well digestive endoscopy, are most useful in evaluating mechanical obstruction. Today the gold standard for the diagnosis of gastroparesis is gastric scintigraphy.
Subject(s)
Male , Female , Gastroparesis/diagnosis , Gastroparesis/etiology , Gastroparesis/therapy , Esophageal Motility Disorders/classification , Esophageal Motility Disorders/physiopathology , Radionuclide Imaging/trends , Radionuclide Imaging , Erythromycin/therapeutic use , Metoclopramide/therapeutic use , Electric Stimulation TherapyABSTRACT
Background: The esophagus can suffer several motor disturbances of striated or smooth muscle. Aim: To determine the presence of primary motor disturbances of the esophagus among a group of patients with esophageal symptoms. Material and methods: Prospective study of 5,440 patients consulting for heartburn, chest pain or dysphagia, with primary esophageal motor disturbances, studied between 1994 and 2004. AH were subjected to an esophageal manometry with eight perfused catheters connected to pressure transducers. Results: Nineteen percent of subjects had a normal esophageal manometry, 60 percent had unspecific motor disturbances usually associated to gastroesophageal reflux, 13 percent had a nutcracker esophagus, 5 percent had diffuse esophageal spasm, 2 percent had achalasia and 0,3 percent had an hypertensive sphincter. Conclusions: Primaryesophageal motor disturbances are common among patients with esophageal symptoms. A manometry should be performed to these patients.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Esophageal Motility Disorders/epidemiology , Chile/epidemiology , Esophageal Motility Disorders/classification , Esophageal Motility Disorders/diagnosis , Manometry , Prospective StudiesABSTRACT
Se describe las características de los trastornos motores esofágicos más frecuentes. Es importante pensar en estos cuadros frente a dolores torácicos de causa no cardíaca. De éstos el más común parece ser el esófago en cascanueces. Se analiza la fisiopatología, clínica, diagnóstico y tratamiento de los principales, haciendo énfasis especial en el tratamiento quirúrgico, el que con el advenimiento de la laparoscopia, representa una buena alternativa frente al tratamiento médico convencional, de tan pobres resultados