ABSTRACT
We review the treatment of esophageal achalasia by means of pneumatic dilatation (PD), analyzing its results and comparing them with those of the literature. We conclude that our personal experience is similar to that of the literature: PD and surgery produce similar results (67-95%), morbidity (2-9.5%), and mortality (0.7-1%); and PD is cheaper than surgery. According to these conclusions, we believe that the decision of the appropriate treatment should be based on a combination of the choice of the properly informed patient and the operator's experience. However, we also conclude that surgery is mandatory in selected cases, such as achalasia associated with hiatus hernia, esophageal diverticula and neoplasia, history of previous PD failure (since in our experience the results after a second PD are very poor), postoperative relapse, and patients with grade IV mega-esophagus according to Resano-Malenchini's classification.
Subject(s)
Catheterization , Esophageal Achalasia/therapy , Argentina/epidemiology , Catheterization/methods , Chagas Disease/complications , Esophageal Achalasia/complications , Esophageal Achalasia/epidemiology , Esophageal Achalasia/etiology , Esophageal Perforation/complications , Esophageal Perforation/diagnosis , Female , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/etiology , Humans , Incidence , Male , Megacolon/complications , Middle Aged , Prevalence , Retrospective Studies , Treatment OutcomeABSTRACT
We report the case of a 36-year-old man with a patch of heterotopic gastric mucosa in the upper esophagus complicated by an esophageal fistula.
