Abstract
Esophageal achalasia is a functional disorder of the esophagus characterized by abnormal motility of the esophageal body (non-peristaltic waves) associated with incomplete, delayed, or absent mechanical and not neurogenic relaxation of the lower esophageal sphincter (LES). The incidence of esophageal achalasia is about 0.311 per million per year (Podas et al. 1998). Only 5% of the patients suffering from this disease are younger than 15 years of age (Mattioli et al. 1997). The association of childhood achalasia with alacrima and adrenal insufficiency in the triple A or Allgrove syndrome is well known (Ambrosino et al. 1986; Huebner et al. 2000; Verma et al. 1999). Associations with other diseases, such as Alports syndrome, mongolism, Hirschsprungs disease, and megacystis-microcolonhypoperistalsis syndrome have also been described (Al Harbi et al. 1999; Kelly et al. 1997; Leichter et al. 1988; Zarate et al. 1999). Familial cases have been reported (Kasgira et al. 1996; Nihoul-Fket et al. 1991). Esophageal achalasia is usually considered an acquired motility disorder. The onset of symptoms is progressive. Almost all the patients present with dysphagia for fluids, called "paroxysmal dysphagia", retention, and regurgitation of undigested food. Chest pain is described in up to 40% of patients. Pulmonary aspiration, failure to thrive, and halitosis are associated symptoms. Many different forms of treatment have been proposed over the past decades such as calcium entry blockers, pneumatic dilatation, and botulin toxin injection. None of these are satisfactory and surgical treatment seems preferable. In 1914, Heller described a double anterior and posterior myotomy for the treatment of "cardiospasm." Later on, Zaaijer et al. proposed an anterior myotomy alone for the same purpose (Heller 1914). In children these techniques should also be associated with a fundoplication aimed at avoiding postoperative reflux and/or at protecting esophageal mucosa (Mattioli et al. 1997; Patti et al. 2001). The technique described here is a laparoscopic anterior esophageal myotomy with partial anterior fundoplication.
| Original language | English |
|---|---|
| Title of host publication | Endoscopic Surgery in Infants and Children |
| Publisher | Springer Berlin Heidelberg |
| Pages | 247-252 |
| Number of pages | 6 |
| ISBN (Print) | 9783540001157 |
| DOIs | |
| Publication status | Published - 2008 |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
Esophageal achalasia. / Mattioli, Girolamo; Prato, Alessio Pini; Castagnetti, Marco; Jasonni, Vincenzo.
Endoscopic Surgery in Infants and Children. Springer Berlin Heidelberg, 2008. p. 247-252.Research output: Chapter in Book/Report/Conference proceeding › Chapter
}
TY - CHAP
T1 - Esophageal achalasia
AU - Mattioli, Girolamo
AU - Prato, Alessio Pini
AU - Castagnetti, Marco
AU - Jasonni, Vincenzo
PY - 2008
Y1 - 2008
N2 - Esophageal achalasia is a functional disorder of the esophagus characterized by abnormal motility of the esophageal body (non-peristaltic waves) associated with incomplete, delayed, or absent mechanical and not neurogenic relaxation of the lower esophageal sphincter (LES). The incidence of esophageal achalasia is about 0.311 per million per year (Podas et al. 1998). Only 5% of the patients suffering from this disease are younger than 15 years of age (Mattioli et al. 1997). The association of childhood achalasia with alacrima and adrenal insufficiency in the triple A or Allgrove syndrome is well known (Ambrosino et al. 1986; Huebner et al. 2000; Verma et al. 1999). Associations with other diseases, such as Alports syndrome, mongolism, Hirschsprungs disease, and megacystis-microcolonhypoperistalsis syndrome have also been described (Al Harbi et al. 1999; Kelly et al. 1997; Leichter et al. 1988; Zarate et al. 1999). Familial cases have been reported (Kasgira et al. 1996; Nihoul-Fket et al. 1991). Esophageal achalasia is usually considered an acquired motility disorder. The onset of symptoms is progressive. Almost all the patients present with dysphagia for fluids, called "paroxysmal dysphagia", retention, and regurgitation of undigested food. Chest pain is described in up to 40% of patients. Pulmonary aspiration, failure to thrive, and halitosis are associated symptoms. Many different forms of treatment have been proposed over the past decades such as calcium entry blockers, pneumatic dilatation, and botulin toxin injection. None of these are satisfactory and surgical treatment seems preferable. In 1914, Heller described a double anterior and posterior myotomy for the treatment of "cardiospasm." Later on, Zaaijer et al. proposed an anterior myotomy alone for the same purpose (Heller 1914). In children these techniques should also be associated with a fundoplication aimed at avoiding postoperative reflux and/or at protecting esophageal mucosa (Mattioli et al. 1997; Patti et al. 2001). The technique described here is a laparoscopic anterior esophageal myotomy with partial anterior fundoplication.
AB - Esophageal achalasia is a functional disorder of the esophagus characterized by abnormal motility of the esophageal body (non-peristaltic waves) associated with incomplete, delayed, or absent mechanical and not neurogenic relaxation of the lower esophageal sphincter (LES). The incidence of esophageal achalasia is about 0.311 per million per year (Podas et al. 1998). Only 5% of the patients suffering from this disease are younger than 15 years of age (Mattioli et al. 1997). The association of childhood achalasia with alacrima and adrenal insufficiency in the triple A or Allgrove syndrome is well known (Ambrosino et al. 1986; Huebner et al. 2000; Verma et al. 1999). Associations with other diseases, such as Alports syndrome, mongolism, Hirschsprungs disease, and megacystis-microcolonhypoperistalsis syndrome have also been described (Al Harbi et al. 1999; Kelly et al. 1997; Leichter et al. 1988; Zarate et al. 1999). Familial cases have been reported (Kasgira et al. 1996; Nihoul-Fket et al. 1991). Esophageal achalasia is usually considered an acquired motility disorder. The onset of symptoms is progressive. Almost all the patients present with dysphagia for fluids, called "paroxysmal dysphagia", retention, and regurgitation of undigested food. Chest pain is described in up to 40% of patients. Pulmonary aspiration, failure to thrive, and halitosis are associated symptoms. Many different forms of treatment have been proposed over the past decades such as calcium entry blockers, pneumatic dilatation, and botulin toxin injection. None of these are satisfactory and surgical treatment seems preferable. In 1914, Heller described a double anterior and posterior myotomy for the treatment of "cardiospasm." Later on, Zaaijer et al. proposed an anterior myotomy alone for the same purpose (Heller 1914). In children these techniques should also be associated with a fundoplication aimed at avoiding postoperative reflux and/or at protecting esophageal mucosa (Mattioli et al. 1997; Patti et al. 2001). The technique described here is a laparoscopic anterior esophageal myotomy with partial anterior fundoplication.
UR - http://www.scopus.com/inward/record.url?scp=84873678694&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873678694&partnerID=8YFLogxK
U2 - 10.1007/978-3-540-49910-7_32
DO - 10.1007/978-3-540-49910-7_32
M3 - Chapter
SN - 9783540001157
SP - 247
EP - 252
BT - Endoscopic Surgery in Infants and Children
PB - Springer Berlin Heidelberg
ER -