Achalasia Cardia – Recent Advances in Diagnosis and Endoscopic Management
نویسندگان
چکیده
Achalasia Cardia is a rare neurodegenerative disorder of esophagus resulting in defective peristalsis and impaired relaxation of lower esophageal sphincter. The exact etiopathogenesis of achalasia is not known. Achalasia is associated with significant morbidity and impaired quality of life. The standard of care in patients with achalasia has been pneumatic balloon dilatation and laparoscopic heller's myotomy. Recent advancements in the diagnosis and endoscopic management have greatly improved the outcomes of this disorder. Subtyping of esophageal motility disorders with high resolution manometry has served to predict treatment outcomes and plan appropriate treatment. Per oral endoscopic myotomy (POEM) is an novel minimally invasive treatment option for all types of achalasia cardia. Short and mid term efficacy are excellent. Randomized trials are required to confirm its superiority over the currently established treatment modalities.
منابع مشابه
The Choice of Myotomy in Achalasia Cardia: Heller's or Per-Oral Endoscopic Myotomy
Achalasia cardia (AC) is a neurodegenerative disease which leads to loss of inhibitory myenteric neurons. This implies that, with the currently available treatment options, we offer palliation but not cure to these patients. Pneumatic balloon dilatation (PBD) has been the only time‐tested endoscopic modality for the management of AC until recently. However, the requirement of repeated dilatatio...
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Objective: Balloon dilatation of Primary Achalasia Cardia (PAC) is usually performed under antegrade endoscopic guidance, with conscious sedation. The main goals of this prospective study were to assess the safety and efficacy of pneumatic dilatation without conscious sedation and to determine the endoscopic signs of effacement of the balloon”waist”. Methodology: Pneumatic dilatation was succes...
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Secondary achalasia due to submucosal invasion of cardia by gastric cancer is a rare condition. We report a case of pseudoachalasia, secondary to the involvement of gastroesophageal junction by poorly differentiated gastric cancer, initially mistaken as idiopathic form. We focus on the difficulty to establish differential diagnosis only on the basis of routine exams and we stress the necessity ...
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