Transabdominal ultrasonography in the diagnosis of achalasia Transabdominal ultrasonography in the diagnosis of achalasia / 第二军医大学学报

ABSTRACT

Objective: To assess the clinical application of transabdominal ultrasonography for the diagnosis of achalasia. Methods: The subjects were divided into 3 groups, with 8 patients suffered from achalasia as patient group, 10 normal individuals and 8 patients with cardiac carcinoma as controls. All subjects received water provocative test to study the lower esophagus and cardia. Sonographic findings were compared between the 3 groups. After treatment by administration of drugs, pneumatic balloon dilation, or intrasphincteric injection of botulinum toxin, the 8 patients were re-examined by TAUS for longitudinal comparison. Results: (1)The normal subjects had no dilation of cardia and lower esophagus before drinking water, but their cardias opened rapidly with the drinking action. (2)All the patients of achalasia were found to have dilation of lower esophagus before taking water. During 10 min continuous TAUS scanning, 5 of 8 demonstrated absence of relaxation of cardias and absence of water from the esophagus into the stomach. The other 3 showed slight and intermittent relaxation of cardias with water flow into the stomach. Thirty minutes after water provocative test, all the 8 patients had water retardation within the lower esophagus. (3)The patients of cardiac carcinoma had an ultrasound feature of cardiac ring enlargement and thickening of cardiac wall without dilation of lower esophagus before water provocative test. Water passed the cardia more slowly. Conclusion: TAUS is a readily accepted examination. It can quickly give reliable diagnostic clues to achalasia. TAUS can also be used for making assessment of therapeutic effect on achalasia.