ABSTRACT
Achalasia is an esophageal motor disorder characterized by increased lower esophageal
sphincter (LES) pressure, diminished-to-absent peristalsis in the distal portion of
the esophagus composed of smooth muscle, and lack of a coordinated LES relaxation
in response to swallowing. These abnormalities are recognized radiographically by
aperistalsis, esophageal dilatation, and decreased opening of the LES, with a characteristic
“bird-beak” appearance. The principal symptom of this disorder is dysphagia and pneumatic
dilatation is designed to alleviate or cure this symptom.
KEYWORDS
Achalasia - balloon dilatation - fluoroscopy - dysphagia
REFERENCES
- 1
Vantrappen G, Hellemans J.
Treatment of achalasia and related motor disorders.
Gastroenterology.
1980;
79
144-154
- 2 Patti M. Achalasia. Emedicine. Available at: http://www.emedicine.com/med/topic16.htm.
Accessed August 2003
- 3
Mayberry J F, Rhodes J.
Achalasia in the city of Cardiff from 1926 to 1977.
Digestion.
1980;
20
248-252
- 4
Mayberry J F, Atkinson M.
Studies of incidence and prevalence of achalasia in the Nottingham area.
Q J Med.
1985;
56
451-456
- 5
Nihoul-Fekete C, Bawab F, Lortat-Jacob S, Arhan P.
Achalasia of the esophagus in childhood. Surgical treatment in 35 cases, with special
reference to familial cases and glucocorticoid deficiency association.
Hepatogastroenterology.
1991;
38
510-513
- 6
Lind C D.
Dysphagia: evaluation and treatment.
Gastroenterol Clin North Am.
2003;
32
553-575
- 7
Fellows I W, Ogilvie A L, Atkinson M.
Pneumatic dilatation in achalasia.
Gut.
1983;
24
1020-1023
- 8
Bennett J R, Bargaza E, Hendrix T R, Siegel C I.
Treatment of achalasia by pneumatic dilatation of the cardia.
Gut.
1968;
9
727
- 9
Patti M G, Pellegrini C A, Arcerito M et al..
Comparison of medical and minimally invasive surgical therapy for primary oesophageal
motility disorders.
Arch Surg.
1995;
130
609-615
- 10
Yon J, Christensen J.
An uncontrolled comparison of treatments for achalasia.
Ann Surg.
1975;
182
672-676
- 11
Katz P O, Gilbert J, Castell D O.
Pneumatic dilatation is effective long-term treatment for achalasia.
Dig Dis Sci.
1998;
43
1973-1977
- 12
Kadakia S C, Wong R KH.
Graded pneumatic dilation using Rigiflex achalasia dilators in patients with primary
oesophageal achalasia.
Am J Gastroenterol.
1993;
88
34-38
- 13
Lambroza A, Schuman R W.
Pneumatic dilation for achalasia without fluoroscopic guidance: safety and efficacy.
Am J Gastroenterol.
1995;
90
1226-1229
- 14
Cox J, Buckton G K, Bennett J R.
Balloon dilatation in achalasia: a new dilator.
Gut.
1986;
27
986-989
- 15
Sabharwal T, Cowling M, Dussek J et al..
Balloon dilation for achalasia of the cardia: experience in 76 patients.
Radiology.
2002;
224
719-724
- 16
Sabharwal T, Cowling M, Dussek J et al..
Balloon dilation for achalasia of the cardia: a day case procedure.
Radiology.
2003;
228
594
- 17
Uthappa M C, Uberoi J, Phillip-Hughes J, Boardman P.
Balloon dilation for achalasia of the cardia: a day case procedure.
Radiology.
2003;
228
594
- 18
Eckardt V F, Aignherr C, Bernhard G.
Predictors of outcome in patients with achalasia treated by pneumatic dilation.
Gastroenterology.
1992;
103
1732-1738
- 19
Vaezi M F, Baker M E, Achkar E et al..
Timed barium oesophagram: better predictor of long-term success after pneumatic dilation
in achalasia than symptom assessment.
Gut.
2002;
50
765-770
- 20
Metman E H, Lagasse J P, d'Alteroche L, Picon L, Scotto B, Barbieux J P.
Risk factors for immediate complications after progressive pneumatic dilation for
achalasia.
Am J Gastroenterol.
1999;
94
1180-1185
- 21
Barkin J S, Guelrud M, Reiner D K et al..
Forceful balloon dilatation: an outpatient procedure for achalasia.
Gastrointest Endosc.
1990;
36
123-126
- 22
Csendes A, Braghetto I, Henriquez A et al..
Late results of a prospective randomised study comparing forceful dilatation and esophagomyotomy
in patients with achalasia.
Gut.
1989;
30
299-304
- 23
Fried R L, Rosenberg S, Goyal R.
Perforation rate in achalasia with polyethylene balloon dilators.
Gastrointest Endosc.
1991;
37
405
- 24
Stark G, Castell D O, Richter J E et al..
Prospective randomized comparison of Brown-McHardy and Microvasive balloon dilators
in treatment of achalasia.
Am J Gastroenterol.
1990;
85
1322-1325
- 25
Borotto E, Gaudric M, Danel B et al..
Risk factors for oesophageal perforation during pneumatic dilatation for achalasia.
Gut.
1996;
39
9-12
- 26
, [No authors listed.]
Esophageal dilation. Guidelines for clinical application.
Gastrointest Endosc.
1991;
37
122-124
- 27
Lobello R, Edwards D AW, Gummer J WP et al..
The antireflux mechanism after cardiomyotomy.
Thorax.
1978;
33
569-573
- 28
Ponce M, Ortiz V, Juan M et al..
Gastroesophageal reflux, quality of life, and satisfaction in patients with achalasia
treated with open cardiomyotomy and partial fundoplication.
Am J Surg.
2003;
185
560-564
- 29
Black J, Vorbach A N, Collis J L.
Results of Heller's operation for achalasia of the oesophagus. The importance of hiatal
repair.
Br J Surg.
1976;
63
949-953
- 30
Nair L A, Reynolds J C, Parkman H P et al..
Complications during pneumatic dilation for achalasia or diffuse esophageal spasm.
Analysis of risk factors, early clinical characteristics, and outcome.
Dig Dis Sci.
1993;
38
1893-1904
- 31
Heimlich H J, O'Connor T W, Flores D C.
Cases for pneumatic dilatation in achalasia.
Ann Otol Rhino Laryngol.
1978;
87
519-522
- 32
Eckardt V F, Kanzler G, Westermeler T.
Complications and their impact after pneumatic dilation for achalasia: prospective
long-term follow-up study.
Gastrointest Endosc.
1997;
45
349-353
- 33
Wehrmann T, Jacobi V, Jung M et al..
Pneumatic dilation in achalasia with a low-compliance balloon: results of a 5-year
prospective evaluation.
Gastrointest Endosc.
1995;
42
31-36
- 34
Nanson E M.
Treatment of achalasia of the cardia.
Gastroenterology.
1966;
51
236-241
- 35
Barnett J L, Eisenmann R, Nostrant T T et al..
Witzel pneumatic dilation for achalasia: safety and long-term efficacy.
Gastrointest Endosc.
1990;
36
482-485
- 36
Vantrappen G, Hellemans J, Deloof W et al..
Treatment of achalasia with pneumatic dilatation.
Gut.
1971;
12
268-275
- 37
Perretta S, Fisichella P M, Galvani C et al..
Achalasia and chest pain: effect of laparascopic Heller myotomy.
J Gastrointest Surg.
2003;
7
692-700
- 38
Eckardt V R, Stauf B, Bernhard G.
Chest pain in achalasia: patient characteristics and clinical course.
Gastroenterology.
1999;
116
1300-1304
- 39
Ali M E.
Achalasia of the cardia in children.
Saudi Med J.
2003;
24
S40
- 40
Fasulakis S, Andronikou S.
Balloon dilatation in children for oesophageal strictures other than those due to
primary repair of oesophageal atresia, interposition or restrictive fundoplication.
Pediatr Radiol.
2003;
33
682-687
, E-pub 2003 Aug 6
Dr. Tarun Sabharwal
Department of Radiology, St Thomas' Hospital
Lambeth Palace Road, London
SE17EH, United Kingdom
Email: Tarun.Sabharwal@gstt.sthames.nhs.uk