RESUMO
40 patients with achalasia underwent pneumatic dilatation. 25 were followed up for a mean duration of 3.96 years. Digestive symptoms disappeared in 32% of cases, were diminished in 40% and remained unchanged in 28%. In 8 patients oesophageal manometry after dilatation showed a significant reduction in lower oesophageal sphincter pressure. The patients showing improvement had a more marked drop in lower oesophageal sphincter pressure, lower residual pressure in the lower oesophageal sphincter measured by wet swallows, and negative pressure in the oesophagus. As complications 3 patients developed oesophageal perforation with one subsequent death, and 3 symptomatic gastro-oesophageal reflux. In view of these results, we regard pneumatic dilatation as the treatment of choice in achalasia.
Assuntos
Cateterismo/métodos , Acalasia Esofágica/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cateterismo/efeitos adversos , Acalasia Esofágica/fisiopatologia , Perfuração Esofágica/etiologia , Junção Esofagogástrica/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , PressãoRESUMO
Of 69 patients with non-cardiac chest pain, one third had abnormal esophageal motility as evidenced by basal esophageal manometry. 8 patients (12%) reported chest pain during a provocation test (edrophonium). While this pain seemed similar to the spontaneous chest pain described by 7 patients, it was not associated with manometric changes in 30% of these cases. The causal relationship between disorders of esophageal motility and non-cardiac chest pain has still to be confirmed, and caution must be exercised in interpreting edrophonium tests.