Achalasia cardia is a neuromuscular disorder of unknown etiology involving the body of the esophagus and lower esophageal sphincter (LES). It is characterized by aperistalsis of the body of the esophagus and failure of relaxation of lower esophageal sphincter. It usually affects patients between the ages of 30 and 60 years. It is unusual in childhood and extremely rare in infants. We report two...

Current parameters of the Chicago classification include assessment of the esophageal body (contraction vigour and peristalsis), lower esophageal sphincter relaxation pressure, and intra-bolus pressure pattern. Esophageal disorders include achalasia, esophagogastric junction outflow obstruction, major disorders of peristalsis, and minor disorders of peristalsis. Sub-classification of achalasia ...

Cholangiocarcinoma most commonly presents as painless progressive jaundice. We report a case occurring in a 56-year-old Chinese woman with an unusual presentation of progressive dysphagia and vomiting. Oesophageal manometric and barium studies were indicative of achalasia, and computed tomography confirmed the presence of cholangiocarcinoma extending to the gastroesophageal junction and proxima...

There is a strong aetiological association between achalasia and squamous carcinoma of the oesophagus, particularly of the middle third. Until now all reported cases have been of advanced tumours, 80% of which have been found unsuitable for resection. We report the first case of squamous carcinoma in situ in a patient with achalasia. It is reasonable to suppose that all tumours go through this ...

Complement fixation tests were performed on sera from 18 patients with achalasia and 12 age- and sex-matched controls against a number of bacterial and viral agents in an attempt to ascertain any association with previous infection or any evidence of an altered immune response. There was a statistically significant increase of antibody titre against measles virus in the sera of 21 patients with...

The clinical significance of minor esophageal motility disorders is unclear, though they typically carry a benign course. Distal esophageal spasm progressing to achalasia has been reported, although it appears to be rare. We report a case of a patient with dysphagia and chest pain who was found to have ineffective esophageal motility on high-resolution manometry, which developed into distal eso...

Triple A Syndrome is an autosomal recessive neurodegenerative disorder characterised by central and peripheral nervous system disturbances, autonomic dysfunction, alacrima, achalasia, and ACTH-resistant adrenal insufficiency (1). It results from mutations in the AAAS gene located on 12q13 which encodes the WD-repeat protein ALADIN (2) (ALacrima Achalasia aDrenal Insufficiency Neurologic disorde...

Transient dysphagia has been described following truncal and selective vagotomy for peptic ulceration. There are considered to be 3 main aetiologies, namely haematoma, oesophagitis and lower oesophageal sphincter spasm. In the latter instance barium swallow may show the changes of achalasia, but previous reports have described either normal oesophageal manometry, or lower oesophageal sphincter ...

We describe a technique for measuring the yield pressure at the cardia during upper gastrointestinal endoscopy. The test was applied to 47 patients with macroscopic oesophagitis and nine patients with achalasia. Controls were 123 patients from the routine endoscopy list in whom no abnormality was found and 21 healthy volunteers. Yield pressure was similar in both control groups, but was signifi...

Allgrove syndrome or triple-Asyndrome is a rare familial multisystem autosomal recessive disorder. It is characterised by triad of alacrima, achalasia and adrenal insufficiency due to adrenocorticotropin hormone (ACTH) resistance. If it is associated with autonomic dysfunction, it is termed as 4-Asyndrome. This syndrome is caused by a mutation in the Achalasia - Addisonism - Alacrima (AAAS) gen...