• 제목/요약/키워드: Esophageal achalasia

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Achalasia 의 1례 (A case of achalasia)

  • 조중환;유태현;박현수
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
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    • pp.9.3-9
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    • 1977
  • Achalasia는 식도의 확장을 동반하는 탐도분문부의 비기질적폐색을 이르키는 질환으로 그 원인은 불명하나 식도하부괄약근의 이완장애와 식도체부에서의 정상연동운동의 결여로 나타나는데 원래 근육신경계의 기능장애의 하나로 중추신경계통의 병변으로 신경 신경절 및 근육의 변성을 이르켜 생긴다는 설이 유력시되고 있다. 주요증상은 연하장애 음식물토출 및 심와부 동통등이다. 저자들은 43세 여자에서의 achalasia 1례를 치험하였기에 문헌적고찰과 함께 보고하는 바이다.

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Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand

  • Tharathorn Suwatthanarak;Chainarong Phalanusitthepa;Chatbadin Thongchuam;Thawatchai Akaraviputh;Vitoon Chinswangwatanakul;Thikhamporn Tawantanakorn;Somchai Leelakusolvong;Monthira Maneerattanaporn;Piyaporn Apisarnthanarak;Jitladda Wasinrat
    • Clinical Endoscopy
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    • 제57권5호
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    • pp.610-619
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    • 2024
  • Background/Aims: Achalasia is a rare esophageal motility disease, for which peroral endoscopic myotomy (POEM) has emerged as a promising treatment option; however, recurrence remains a challenge. Timed barium esophagography (TBE) is a useful diagnostic tool and potential outcome predictor of achalasia. This study aimed to determine predictive tools for recurrence after POEM. Methods: This retrospective study enrolled achalasia patients who underwent POEM between January 2015 and December 2021. Patients were categorized into two groups using the 1-month post-POEM Eckardt scores and TBE: the discordant group (Eckardt score improved >50%, TBE decreased <50%) and the concordant group (both Eckardt score and TBE improved >50%). Recurrence was defined as a reincrease in the Eckardt score to more than three during follow-up. Results: Complete medical records were available in 30 patients who underwent POEM. Seventeen patients (56.7%) were classified into the discordant group, while 13 patients (43.3%) were in the concordant group. The overall recurrence rate was 11.9% at 1-year, increasing to 23.8% during the extended follow-up. The discordant group had a 6.87 fold higher recurrence rate than the concordant group (52.9% vs. 7.7%, p=0.017). Conclusions: These results strongly suggest that combining the Eckardt score with TBE can effectively predict recurrent achalasia after POEM. Patients in the discordant group had an elevated risk.

흉강경을 이용한 식도천공과 이완불능증에 대한 수술 -2예 보고 - (Thoracoscopic Surgery for Esophageal Perforation and Achalasia - Two cases report -)

  • 오세진;김형렬;임청;박계현;성숙환;전상훈
    • Journal of Chest Surgery
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    • 제40권9호
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    • pp.655-658
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    • 2007
  • 식도천공은 비교적 드물지 않게 볼 수 있고 종종 치명적인 결과를 야기하므로 응급 수술을 필요로 한다. 식도 천공에 대한 수술은 개흉술을 통한 일차 봉합이 대부분이었으나 최근 들어 흉강경 수술 접근을 통해 동등한 결과를 보이고 있다. 뵈르하베 증후군 및 식도이완불능증에 대한 공기 확장술 중 발생한 식도천공 환자에 대해 흉강경을 이용한 일차 봉합술 및 근 절개술을 시행하여 좋은 결과를 보인 두 증례를 보고하는 바이다.

개에서의 윤상인두근 이완불능증의 진단 및 수술적 치료 1예 (Diagnosis and surgical management of cricopharyngeal achalasia in a dog)

  • 최호정;정성목
    • 대한수의학회지
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    • 제46권1호
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    • pp.57-61
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    • 2006
  • A 3-month-old, 2.8 kg, female Cocker spaniel was presented with chronic history of dysphagia since weaning. Video fluoroscopic examination revealed swallowing problems in the upper esophageal sphincters. It was diagnosed as cricopharyngeal achalasia. Cricopharyngeal and thyropharyngeal myectomy was performed. One day after surgical management, normal swallowing movement was observed in the video fluoroscopic examination of the dog. There was no evidence of recurrence for 15 months.

식도이완불능증에시 복강경을 이용한 식도근절개술 및 전방위저주름술 - 1예 보고 - (Laparoscopic Heller Myotomy with Dor Fundoplication in Achalasia -One case report -)

  • 김연수;류지윤
    • Journal of Chest Surgery
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    • 제38권3호
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    • pp.258-262
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    • 2005
  • 환자는 18세 여자로 6년 전부터 연하곤란 및 식사 후 빈번하게 구토가 발생하였으며, 최근 6개월 동안 15 kg의 체중 감소가 있었다. 식도 계측검사에서 식도이완불능증으로 진단되었다. 약물치료를 하였으나 증상이 호전되지 않아 복강경을 이용한 수술을 결정하였다. 복부에 5개의 트로카용 소절개를 시행하였고, 복강경을 이용하여 근절개술과 전방위저부주름술을 시행하였다. 수술 후 1일째 식도조영술을 시행하였다. 조영제가 누출 없이 원활하게 통과되었다. 수술 후 2일째 식이를 시행하였으며, 술 후 9일째 특별한 문제없이 퇴원하였다.

식도의 점믹하 해리;1례 보고 (Submucosal Dissection of the Esophagus)

  • 김영진
    • Journal of Chest Surgery
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    • 제25권10호
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    • pp.1093-1097
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    • 1992
  • Injury to the esophagus varies from a minor superficial tear to complete rupture of the esophageal wall. We have recently seen one healthy adult male who sustained submucosal dissection of the esophagus while endoscopy. The diagnosis has been made by esophagogram and chest computed tomogram. The therapy was conservative management and good prognosis without complications.

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식도 Achalasia 의 외과적 치료 -6례 보고- (Surgical Treatment of Esophageal Achalasia - Report of 6 cases -)

  • 박성달
    • Journal of Chest Surgery
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    • 제22권5호
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    • pp.811-815
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    • 1989
  • Six cases of achalasia were treated by modified Hellers operation at the department of thoracic % cardiovascular surgery of Kosin medical college from April 1984 to July 1988. Among 6 cases, 4 were male and 2 were female. Preoperative main symptoms were dysphagia in 5 cases and regurgitation in 1 case, its duration was variable from 1.5 years to 40 years. Esophagocardiomyotomy was perfomed in all cases, and the results were excellent to good, but reoperation was needed in one case due to incomplete myotomy. One case of advanced achalasia was also experienced and the result was satisfactory. Antireflux procedures were not performed in all cases and there was no reflux esophagitis on follow-up study.

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식도 아칼라지아의 외과적 치료 (Surgical Management of Esophageal Achalasia)

  • 김주현
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.745-750
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    • 1987
  • 30 case of achalasia treated by modified Heller`s myotomy at the department of thoracic surgery of Seoul National University Hospital from 1965 to 1987 were analyzed. Preoperative Symptoms were alleviated completely or partially in 90% of the 30 patients who were available for follow up study [average: 3.6 years]. Excellent or good results were achieved in 83.3% of patients. Only two of the poor results were due to reflux esophagitis. It is concluded that an antireflux procedure is not routinely necessary to prevent postoperative reflux esophagitis if the technique of espohagomyotomy is used properly.

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Acquired noncaustic esophageal strictures in children

  • Sag, Elif;Bahadir, Aysenur;Imamoglu, Mustafa;Sag, Sefa;Reis, Gokce Pinar;Erduran, Erol;Cakir, Murat
    • Clinical and Experimental Pediatrics
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    • 제63권11호
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    • pp.447-450
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    • 2020
  • Background: Esophageal stricture (ES) is an uncommon clinic entity in pediatrics that may be congenital or acquired in childhood. Acquired noncaustic ES is very rare, and clinical features of affected patients are unknown. Purpose: We aimed to evaluate the clinical findings, and outcomes of patients with acquired noncaustic ES to aid physicians in the early referral of patients to gastroenterologists. Methods: The medical data of patients with acquired noncaustic ES who were followed in our gastroenterology clinic between January 2009 and December 2019 were reviewed. Results: Acquired noncaustic ES was found in 12 of the 4,950 patients (0.24%) who underwent endoscopy during the study period. The main symptoms were dysphagia (58.3%), vomiting (33.3%), and chronic anemia (8.3%). Chronic malnutrition and underweight were found in 66.6% of the patients. The most common etiological factors were radiotherapy, peptic reflux, and achalasia (16.6%, each), while chemotherapy, squamous-cell carcinoma (SC) of the esophagus, eosinophilic esophagitis (EoE), esophageal web, epidermolysis bullosa, and esophageal diverticulum (8.2%, each) were the other etiological factors. Patients with EoE underwent endoscopic bougie dilation in addition to steroid use and elimination diet. Patients with epidermolysis bullosa and esophageal web underwent bougie dilation. Patients with peptic reflux-related ES were initially put on antireflux therapy, but during follow-up, one patient required esophageal replacement with colonic interposition. Patients with radiotherapy-related ES recovered with medical therapy. The patient with initially underwent surgical gastrostomy and tumoral mass excision. The patient then received chemotherapy and radiotherapy and underwent jejunal interposition. Patients with achalasia underwent surgical esophagomyotomy. Conclusion: The presence of solid dysphagia, malnutrition, and an associated disease may alert physicians to the presence of ES.