Acalasia y otros trastornos motores del esófago / Achalasia and other motor disorders of the esophagus

El esófago tiene una longitud de 20 cm. Aproximadamente 5 por ciento del esófago proximal, incluyendo el esfinter esofágico superior (ESS) y la musculatura orofaríngea, están constituidos por músculo estriado.Desde el punto de vista clínico y gastroenterológico, los transtornos de la musculatura lisa son los mas frecuentes e importantes. Se clasifican en dos grandes grupos: transtornos primarios, cuando se presentan sin relación a alguna otra enfermedad y trastornos secundarios, cuando son consecuencia de una enfermedad sistémica.

Malformación vascular de Dieulafoy como causa de hemorragia gástrica masiva y recurrente / Massive recurrent gastric bleeding in patients with Dieulafoy's vascular malformation

We demonstrated a Diulafoy type vascular malformation in 10 patients with upper gastrointestinal bleeding. Most patients had a history of prior bleeding and were older than 60 years of age. A mean fo 2.6 endoscopic examinations had been performed, and a mean of 2500 ml of blood transfused per patient. A localized ressection of the lesion was performed in 9 patients and a partial gastrectomy in the remaining. Sugery was performed as an emergency in 5 patients. The lesion was a small, 2 to 5 mm, erosion localized in the subcardial region. The vascular nature of the lesion was confirmed by histologic study in all cases. Postoperative couse was uneventful in all patients and no recurrences have been observed