title: Mechanical and neurogenic factors in postvagotomoy dysphagia.
abstract: Postvagotomy dysphagia (PVD) has been attributed to either periesophageal obstruction or failure of the lower esophageal sphincter (LES) to relax, presumably from interruption of preganglionic, contraction-inhibiting vagal fibers--a postvagotomy achalasia (PVA). This report describes a patient with periesophageal fibrosis which was successfully treated with dilation, and a second patient with an achalasia-like pattern on esophageal manometry after unilateral high, transthoracic vagotomy. The second patient is the first manometrically documented example of achalasia in a human subject related to proximal vagotomy. Most, if not all, PVD is due to esophageal obstruction and PVA is rare.
mesh_terms: D000328:Adult; D003680:Deglutition Disorders / Q000209:etiology*; D004931:Esophageal Achalasia / Q000209:etiology; D004935:Esophageal Diseases / Q000209:etiology; D004947:Esophagus / Q000294:innervation / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D014628:Vagotomy / Q000009:adverse effects*; D014629:Vagotomy, Proximal Gastric / Q000009:adverse effects*; D014630:Vagus Nerve / Q000033:anatomy & histology